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BMJ 2006; 332 doi: (Published 20 April 2006) Cite this as: BMJ 2006;332:966
  1. Christopher Martyn, associate editor (

    Effects of pneumococcal vaccine extend beyond vaccinated group

    Since 2000 in the United States, a pneumococcal conjugate vaccine has been recommended for all under 2 year olds and for older children with chronic illness or who are otherwise at high risk of infection. Initial results were encouraging, but the long term effects of vaccination programmes are not always predictable. Continuing surveillance now shows that the benefits are sustained and that they extend more widely than expected.

    Researchers monitored about 15 million people living in eight areas of the US from 1996 to 2004. After the introduction of the vaccine into the routine childhood immunisation schedule, incidence of antibiotic resistant invasive disease declined substantially. Rates fell by 81% in under 2 year olds. In children aged 2-4 years, rates fell by 60%. Less easy to anticipate was the reduction in the rate of invasive disease in older children and adults who had not received the vaccine. The probable explanation is that the vaccine interrupts the transmission of resistant pneumococci from children to adults.

    The vaccine targets seven pneumococcal serotypes that are known to be responsible for most antibiotic …

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