As individuals advance in age, the risk of infection, bacteremia, and mortality caused by Streptococcus pneumoniae rises. Retrospective data demonstrate that the licensed penumococcal polysaccharide vaccine (PPV) is effective in older persons in reducing serotype-specific invasive disease. PPV demonstrates good immunogenicity in older adults, generally comparable to that in younger subjects, although certain cohorts respond less well. The response to PPV is T cell independent, however, and does not elicit immunologic memory. The duration of the anti-capsular polysaccharide antibody response appears to wane as early as 3 years after vaccination. In older persons, revaccination induces an antibody response, although it may not be as strong as that from the initial vaccine. While revaccination of older adults has been recommended, clinical efficacy has not yet been proven. Measures of antibody function may be at least as important in determining protection as are quantitative antibody levels. Additional studies of immunogenicity, particularly regarding revaccination, will facilitate the design of an optimal pneumococcal vaccination policy. Research into conjugate- and protein-based pneumococcal vaccines, which elicit T-cell-dependent responses and induce immunologic memory, is needed in older persons. In the meantime, administering to PPV to recommended groups should be a public health priority.

中文翻译：

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老年人的肺炎球菌疫苗接种和重新接种。


随着个体年龄的增长，肺炎链球菌引起的感染、菌血症和死亡的风险也会增加。回顾性数据表明，获得许可的肺炎球菌多糖疫苗（PPV）可有效减少老年人血清型特异性侵袭性疾病。 PPV 在老​​年人中表现出良好的免疫原性，通常与年轻受试者相当，尽管某些群体的反应较差。然而，对 PPV 的反应是 T 细胞独立的，并且不会引发免疫记忆。抗荚膜多糖抗体反应的持续时间似乎早在疫苗接种后 3 年内就会减弱。对于老年人，重新接种疫苗会引起抗体反应，尽管抗体反应可能不如初始疫苗那么强烈。虽然建议老年人重新接种疫苗，但临床疗效尚未得到证实。在确定保护方面，抗体功能的测量至少与定量抗体水平一样重要。免疫原性的额外研究，特别是关于重新接种的研究，将有助于设计最佳的肺炎球菌疫苗接种政策。需要对基于结合物和蛋白质的肺炎球菌疫苗进行研究，这种疫苗可在老年人中引发 T 细胞依赖性反应并诱导免疫记忆。与此同时，对推荐人群实施 PPV 应成为公共卫生优先事项。