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Prof Adam Finn @ MRF's Meningitis and Septicaemia 2019


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Debate - pneumococcal vaccination - is a second year of life booster needed for herd protection?

Published in: Health & Medicine
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Prof Adam Finn @ MRF's Meningitis and Septicaemia 2019

  1. 1. PCV in developing countries Give 2+1 Adam Finn @adamhfinn Bristol Childrens Vaccine Centre MRF 5th Nov 2019, London
  2. 2. Is this your ideal perspective?
  3. 3. ..or do you prefer to take the broader view?
  4. 4. PCVs have important indirect effects
  5. 5. This is not new... Lancet Infectious Diseases 2001
  6. 6. Salivary antibody responses Choo et al. JID 2000 182
  7. 7. Functional antibody after priming wanes..
  8. 8. Functional antibody after boosting persists..
  9. 9. More antibody.. Madhi & Nunes Hum Vaccin Immunother. 2016 Feb; 12(2): 314–325
  10. 10. VT carriage - Kenya Hammitt et al Lancet Glob Health. 2014 Jul;2(7):e397-405
  11. 11. ..and, of course, it’s not just about indirect protection..
  12. 12. From 12 months post-dose 3, the odds of VT IPD by 24–36 months increased significantly for PCV7 (5.6, 95% CI, 1.2– 25.4) and PCV13 (5.9, 95% CI, 1.0–35.2).
  13. 13. So: • 3+0 provides direct protection for a limited period – as shown in 2 RCTs. • For people with blinkers it’s a dead cert to do that – and only that • 2+1 provides both sustained direct and indirect protection across the population • For people with a broader perspective it’s the obvious choice • More evidence on 2+1 is coming soon