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Pressure mounts for infant pneumococcal vaccine

Government scientists have concluded that the weight of evidence now supports adding pneumococcal vaccine to the UK childhood immunisation schedule.

New research from the US Centres for Disease Control (CDC) has revealed incidence of invasive pneumococcal disease fell dramatically in vaccinated children and there had also been significant drops in adults and unimmunised children.

Dr Mary Ramsay, consultant epidemiologist at the UK Health Protection Agency, said: 'The US experience with herd immunity makes it much more likely we could justify introducing the vaccine.'

Dr Cynthia Whitney from the US CDC told the International Conference on Emerging Infectious Diseases in Atlanta recently that rates of invasive pneumococcal disease in children aged two to 23 months had fallen by 94 per cent in the past two years. And encouragingly, incidence in older children who had not been vaccinated and adults had also dropped significantly, she said.

'We were pretty confident when we recommended this vaccine for children it would help them,' said Dr Whitney. 'What was a pretty pleasant surprise was the amount of benefit we've seen in the unvaccinated population.'

Dr Whitney said the evidence supported the theory that young children act as a reservoir for the bacteria in the general population.

'We are vaccinating children and the children in turn are not passing the bacteria on to adults and other children,' she added. 'Overall the vaccine has done a great job of preventing disease.'

In the UK, a phased introduction of pneumococcal conjugate vaccine in patients over 65 began in 2003 but the Joint Committee on Vaccination and Immunisation has so far held out against adding the vaccine to the childhood immunisation schedule.

Evidence on the safety of the conjugate vaccine used in the USA childhood schedule has been compiled by the Health Protection Agency and was presented to the JCVI in

February.

Dr Ramsay said because the UK had a lower incidence of pneumococcal disease than the US, more justification was needed to introduce it.

A Department of Health spokesman told Pulse: 'The JCVI found the preliminary results encouraging but did not believe the results were sufficient to alter its position.

'They have recommended that a subgroup of experts is set up to examine all the evidence, including the new US data, in detail.'

Future changes to UK vaccine policy

Several changes to UK vaccination policy are likely over the next few years, Dr Mary Ramsay, consultant epidemiologist at the Government's Health Protection Agency, told an immunisation conference in London last week.

Introduction in UK almost definite

lInactivated polio lAcellular pertussis

New target groups of patients likely to be added to those already recommended for immunisation

lHepatitis B lPneumococcal lVaricella

Need not yet established

lInfluenza in children outside at-risk groups

No current UK need lMeningococcal ACWY conjugate

Problematic development lMeningitis B

Safety concerns lRotavirus

By Emma Wilkinson

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