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. 1999 May-Jun;5(3):336–345. doi: 10.3201/eid0503.990304

Bacterial vaccines and serotype replacement: lessons from Haemophilus influenzae and prospects for Streptococcus pneumoniae.

M Lipsitch 1
PMCID: PMC2640786  PMID: 10341170

Abstract

Conjugate vaccines have reduced the incidence of invasive disease caused by Haemophilus influenzae, type b (Hib), in industrialized countries and may be highly effective against Streptococcus pneumoniae. However, the serotype specificity of these vaccines has led to concern that their use may increase carriage of and disease from serotypes not included in the vaccine. Replacement has not occurred with the use of Hib vaccines but has occurred in trials of pneumococcal vaccines. Mathematical models can be used to elucidate these contrasting outcomes, predict the conditions under which serotype replacement is likely, interpret the results of conjugate vaccine trials, design trials that will better detect serotype replacement (if it occurs), and suggest factors to consider in choosing the serotype composition of vaccines.

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Selected References

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  1. Austrian R. Some aspects of the pneumococcal carrier state. J Antimicrob Chemother. 1986 Jul;18 (Suppl A):35–45. doi: 10.1093/jac/18.supplement_a.35. [DOI] [PubMed] [Google Scholar]
  2. Barbour M. L. Conjugate vaccines and the carriage of Haemophilus influenzae type b. Emerg Infect Dis. 1996 Jul-Sep;2(3):176–182. doi: 10.3201/eid0203.960303. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Centers for Disease Control and Prevention (CDC) Progress toward elimination of Haemophilus influenzae type b disease among infants and children--United States, 1987-1995. MMWR Morb Mortal Wkly Rep. 1996 Oct 25;45(42):901–906. [PubMed] [Google Scholar]
  4. Farley M. M., Stephens D. S., Brachman P. S., Jr, Harvey R. C., Smith J. D., Wenger J. D. Invasive Haemophilus influenzae disease in adults. A prospective, population-based surveillance. CDC Meningitis Surveillance Group. Ann Intern Med. 1992 May 15;116(10):806–812. doi: 10.7326/0003-4819-116-10-806. [DOI] [PubMed] [Google Scholar]
  5. Johanson W. G., Jr, Blackstock R., Pierce A. K., Sanford J. P. The role of bacterial antagonism in pneumococcal colonization of the human pharynx. J Lab Clin Med. 1970 Jun;75(6):946–952. [PubMed] [Google Scholar]
  6. Kelly T., Dillard J. P., Yother J. Effect of genetic switching of capsular type on virulence of Streptococcus pneumoniae. Infect Immun. 1994 May;62(5):1813–1819. doi: 10.1128/iai.62.5.1813-1819.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Levin B. R., Bull J. J. Short-sighted evolution and the virulence of pathogenic microorganisms. Trends Microbiol. 1994 Mar;2(3):76–81. doi: 10.1016/0966-842x(94)90538-x. [DOI] [PubMed] [Google Scholar]
  8. Moxon E. R. The carrier state: Haemophilus influenzae. J Antimicrob Chemother. 1986 Jul;18 (Suppl A):17–24. doi: 10.1093/jac/18.supplement_a.17. [DOI] [PubMed] [Google Scholar]
  9. Obaro S. K., Adegbola R. A., Banya W. A., Greenwood B. M. Carriage of pneumococci after pneumococcal vaccination. Lancet. 1996 Jul 27;348(9022):271–272. doi: 10.1016/s0140-6736(05)65585-7. [DOI] [PubMed] [Google Scholar]
  10. Reichler M. R., Allphin A. A., Breiman R. F., Schreiber J. R., Arnold J. E., McDougal L. K., Facklam R. R., Boxerbaum B., May D., Walton R. O. The spread of multiply resistant Streptococcus pneumoniae at a day care center in Ohio. J Infect Dis. 1992 Dec;166(6):1346–1353. doi: 10.1093/infdis/166.6.1346. [DOI] [PubMed] [Google Scholar]
  11. Sanders C. C., Sanders W. E., Jr, Harrowe D. J. Bacterial interference: effects of oral antibiotics on the normal throat flora and its ability to interfere with group A streptococci. Infect Immun. 1976 Mar;13(3):808–812. doi: 10.1128/iai.13.3.808-812.1976. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Schuchat A., Robinson K., Wenger J. D., Harrison L. H., Farley M., Reingold A. L., Lefkowitz L., Perkins B. A. Bacterial meningitis in the United States in 1995. Active Surveillance Team. N Engl J Med. 1997 Oct 2;337(14):970–976. doi: 10.1056/NEJM199710023371404. [DOI] [PubMed] [Google Scholar]
  13. Smith T., Lehmann D., Montgomery J., Gratten M., Riley I. D., Alpers M. P. Acquisition and invasiveness of different serotypes of Streptococcus pneumoniae in young children. Epidemiol Infect. 1993 Aug;111(1):27–39. doi: 10.1017/s0950268800056648. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Sutton A., Schneerson R., Kendall-Morris S., Robbins J. B. Differential complement resistance mediates virulence of Haemophilus influenzae type b. Infect Immun. 1982 Jan;35(1):95–104. doi: 10.1128/iai.35.1.95-104.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]

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