The clinical use of adjuvants in pneumococcal vaccination: Current status and future perspectives

Abstract

Pneumococcal infection disproportionally affects infants, elderly and persons with chronic diseases such as HIV and cancer. Healthy infants normally mount a protective antibody response following pneumococcal conjugate vaccination, but persons in other risk groups are often hypo-responsive to immunization with the licensed pneumococcal polysaccharide and pneumococcal conjugate vaccines. The addition of vaccine adjuvants can potentially overcome hypo-responsiveness in these individuals by augmenting the innate and adaptive immune responses. Vaccine adjuvants may also enhance the immunogenicity of highly purified or recombinant antigens, lead to antigen sparring and reduce the number of immunizations required to achieve protective immunity. Numerous adjuvants have been tested in conjunction with pneumococcal polysaccharides and protein-conjugated polysaccharides in animal immunization studies. However, only a small portion of these adjuvants has progressed to clinical trials. This commentary looks at the clinical experiences with the use of adjuvants in pneumococcal immunization and discusses future perspectives for the development of adjuvanted pneumococcal vaccines. © 2011 Landes Bioscience.