SAN DIEGO-A new pneumococcal vaccine could make bacterial meningitis a rare disease among infants and toddlers.
The experimental vaccine against Streptococcus pneumoniae (Wyeth Lederle) reduced invasive disease by 90% among 19,000 babies immunized at 2, 4, and 6 months of age and given a booster dose between 12 and 15 months, says Dr. Steven Black of Kaiser Permanente in Northern California.
They were among 38,000 infants his team randomized to either the pneumococcal conjugate vaccine or a meningococcus type C conjugate, then followed with active surveillance and serotyping of all specimens for evidence of meningitis, bacteremia, pneumonia, or otitis media.
The study, begun in October 1995, ended early when an initial look last July suggested 100% efficacy against invasive disease. After trialists broke the code, the final tally found 27 cases of meningitis or bacteremia among controls and just three-all caused by pneumococcal strains not included in the vaccine-in the experimental group.
Results are still pending on the vaccine’s efficacy against otitis and pneumonia, as well as its cost-effectiveness, Dr. Black told the Interscience Conference on Antimicrobial Agents and Chemotherapy here. But he’s optimistic that the vaccine will work equally well for both. Newer vaccine versions under development will protect against more bacterial strains, he says.
Though childhood meningitis in the U.S. has declined by nearly 90% since the introduction of vaccines against Haemophilus influenzae in 1990, pneumococci are the biggest causes of the remaining cases here, and a major cause of otitis, which accounts for up to a quarter of all pediatric physician visits. Worldwide, pneumococcal infections kill some 1.2 million children under age 5 every year. -Judy Ismach
SAN DIEGO-A new pneumococcal vaccine could make bacterial meningitis a rare disease among infants and toddlers.
