PERSONAL PRACTICE

Should the new pneumococcal vaccine be used in high-risk children?

A Finn¹, R Booy³, R Moxon⁴, M Sharland², P Heath²

¹ Institute of Child Health, University of Bristol, UK
² St George's Vaccine Institute and St George's Hospital Medical School, Tooting, London, UK
³ Royal London Hospital, Whitechapel, London, UK
⁴ Oxford Vaccine Group, Oxford, UK

Correspondence to:
Correspondence to:
Prof. A Finn, Institute of Child Health, UBHT Education Centre, Level 6, Upper Maudlin St, Bristol BS2 8AE, UK;
Adam.Finn{at}bristol.ac.uk

A new conjugate 7-valent vaccine to prevent pneumococcal infection (Prevenar, Wyeth) has recently received a European licence for use in young healthy children. The vaccine is not currently included in the universal immunisation schedule in the UK or elsewhere in Europe, although it is being used widely in the USA. Its availability for purchase raises the question whether paediatricians should consider using it in high risk children, including those for whom the polysaccharide 23-valent vaccine was previously recommended, until (or unless) it is introduced into general use—indeed the Chief Medical Officer for England and Wales has recently made a recommendation regarding such children aged less than 2 years. We review the evidence concerning use of the vaccine in such children and make suggestions as to how the vaccine may be used while further information is collected.

Keywords: pneumococcal vaccine; Prevenar

Abbreviations: AAP, American Academy of Paediatrics; CSF, cerebrospinal fluid; SCD, sickle cell disease

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