Prevention of Pneumococcal Disease by Vaccination: Does Serotype Replacement Matter? (go to link below)
Lancet (10/07/00) Vol. 356, No. 9237, P. 1210; Spratt, Brian G.; Greenwood, Brian M.

In a commentary, researchers from the Wellcome Trust Centre for the Epidemiology of Infectious Disease and the London School of Hygiene and Tropical Medicine write that conjugate pneumococcal vaccines have been effective at preventing invasive disease, caused by isolates of vaccine serotypes. Yet long-term efficacy must be considered. The pneumococcal conjugate vaccines target only between seven and 11 serotypes out of 90, and affect the prevalence of nasopharyngeal carriage. This could lead to an increase in invasive disease caused by different non-vaccine serotypes. Penicillin resistance is another factor to consider during serotype replacement. It is possible that variants of penicillin-resistant clones with non-vaccine serotypes could lead to outbreaks. The authors suggest that the conjugate vaccine be considered, although it is not a complete solution for pneumococcal disease.

ALL INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR LEGAL ADVICE.  THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.
 
Bacterial Vaccines and Serotype Replacement: Lessons from Haemophilus influenzae and Prospects for Streptococcus pneumoniae