Can Vaccines Control Resistance? The Example of Pneumococcal Conjugate Vaccine

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Abstract
Pneumococcal infections are a major cause of death and disability worldwide, and the emergence of resistance to commonly used drugs over the last 2 decades has made treating these infections even more difficult. Because only a few of the 90 known pneumococcal serotypes cause most resistant infections, vaccines that target these few serotypes could have a major effect on resistant disease. Data from clinical trials and now from 5 years of experience in the United States suggest that pneumococcal conjugate vaccines can significantly reduce carriage, otitis media, and invasive disease caused by resistant strains. Not only is the vaccine beneficial for young children who receive it, but resistant infections have decreased in the United States among adults because of reduced transmission of resistant strains from children. The challenge will be to maintain this early benefit from vaccination, as pneumococcus has repeatedly shown a remarkable ability to adapt to its environment and new strains not covered by conjugate vaccines could start to become resistant.

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