Pneumococcal vaccination in infants and young children Epidemiological and immunological basis of pediatric pneumococcal vaccination

Streptococcus pneumoniae causes various childhood diseases. Invasive pneumococcal diseases (IPD) are rare. They mainly affect infants and toddlers and can have a severe or fatal course. Pneumococcal vaccines are the most effective form of prevention. This article provides an overview of the current epidemiological situation of IPD in childhood in Germany, the available vaccines and the immunological basis of pediatric pneumococcal vaccination. Data from the German Paediatric Surveillance Unit (GPSU) on IPD in children and adolescents under 16 years of age were analyzed. In addition, published data on the serotype distribution, the safety and effectiveness of pneumococcal conjugate vaccines (PCV) and vaccination coverage in Germany are presented. The pneumococcal immune defence and the mode of action of conjugate vaccines as well as the current recommendations of the Standing Committee on Vaccination (STIKO) at the Robert Koch Institute and aspects of its implementation are explained. As the main disease burden of IPD is in infancy, the STIKO recommends early pneumococcal vaccination for all infants as well as for children and adolescents with certain underlying diseases. Nevertheless, in Germany currently around 25% of all children up to their 2nd birthday are not or not fully immunized against pneumococci.