Efficacy of pneumococcal conjugate vaccine in children

Streptococcus pneumoniae is a common cause of meningitis, sepsis, pneumonia , acute otitis media, and sinusitis in children. Children younger than 24 m onths have the highest rates of invasive pneumococcal infections (Germany 1 997-1999: 19.5/100000/year). Pneumococcal infections cause in Germany 220-2 50 cases of meningitis, about 50000 of pneumonia (children younger than 5 y ears) and more than 1 million cases of otitis media (children) annually. Th e case-fatality rate for invasive pneumococcal diseases is high (1997-1999 5.5%, meningitis 8.3%). 20-30% of survivors from meningitis suffer from CNS -related sequelea. In children up to 2 years vaccination with the heptavale nt pneumococcal conjugate vaccine can reduce invasive pneumococcal diseases by about 80% and otitis media and recurrent otitis media by 6% and 9-16%, respectively. Due to the increased risk of pneumococcal infections in the f irst two years of live all children of this age group should be vaccinated. The high rate of resistance of pneumococci against macrolides in Germany, the high rate of non-licensed antibiotics in infants and the inefficacy of the 23-valent vaccine in children younger than 2 years makes the new vaccin e to a necessary alternative.