A Vaccine's Unintended Consequences
When a new vaccine was approved in 2000, experts hoped it would protect children against a common bacteria that causes a variety of illnesses, including meningitis. They were not disappointed. The vaccine, known as Prevnar, has resulted in a sharp drop in cases. The question was: Would it also reduce cases in adults?
A new study led by Lee Harrison of the University of Pittsburgh says the answer is yes. An analysis of data collected at eight centers around the country between 1998 and 2005 by the federal Centers for Disease Control and Protection found that overall there was a 30 percent drop in pneumococcal meningitis caused by strains of the bacteria Streptococcus pneumoniae.
The study, in today's New England Journal of Medicine, found that, as expected, the biggest drop occurred in children under age 2, among whom cases fell by 64 percent. But there was also a 54 percent drop in cases among the elderly--presumably because the fall in infections among children meant fewer kids were spreading the pathogen to adults.
The news, however, is not all good. At the same time, there was a 60 percent increase in strains of the bacteria not covered by the vaccine. The reduction in those covered by the vaccine probably created a void that the other strains filled, the researchers speculated. Perhaps even more worrisome, there was an increase in the number of cases caused by strains of the bacteria resistant to antibiotics. That's probably because as the other strains became more common and doctors started treating them with antibiotics they developed more resistance.
None of this means that children should not continue to receive the vaccine. Quite the opposite. But it does mean that doctors should be as judicious as possible about using antibiotics to minimize the chances that the antibiotic resistant strains will become more common. The findings give impetus to drug makers to speed the development of new versions of the vaccine to cover more strains. And that work is already underway.
January 15, 2009; 7:00 AM ET
Categories: Family Health
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