ЭФФЕКТИВНОСТЬ ПНЕВМОКОККОВЫХ КОНЪЮГИРОВАННЫХ ВАКЦИН СЛЕДУЮЩЕГО ПОКОЛЕНИЯ В РАЗНЫХ РЕГИОНАХ МИРА

Приводится обзор последних публикаций и текстов докладов по клиническим исследованиям и данным эффективности применения 10- и 13-валентной пневмококковых конъюгированных вакцин (ПКВ10 и 13) в разных странах мира для прогнозирования ожидаемого эффекта массовой иммунизации детей в России в связи с включением вакцинации против пневмококковой инфекции в Национальный календарь прививок c 1 января 2014 г. На основе проанализированных данных сделан вывод о высокой эффективности указанных вакцин в отношении инвазивных пневмококковых инфекций (ИПИ) при использовании схемы 3+1. Эффективность в отношении ИПИ при схеме 2+1 для ПКВ10 определена на уровне 85,8% (Финляндия), для ПКВ13 — 100% (Норвегия). Серотип-специфическая эффективность в отношении ИПИ для ПКВ10 определена только по серотипам 6В и 14, в то время как для ПКВ13 продемонстрирована при схемах 2+1 и 3+1 не только по общим с 7-валентной пневмококковой конъюгированной вакциной (ПКВ7) серотипам, но и в отношении дополнительных серотипов 1, 6А, 7F, 19А. По сравнению с ПКВ7, в отношении пневмоний и средних отитов ПКВ10 не показала дополнительных преимуществ (исследования COMPAS и FinIP), в то время как ПКВ13 продемонстрировала дальнейшее снижение заболеваемости и более высокую эффективность в отношении этих заболеваний (США, Израиль, Франция, Уругвай, Аргентина, ЮАР). Стойкое, выраженное и статистически достоверное снижение носительства вакцинальных серотипов и популяционный эффект (снижение заболеваемости ИПИ в невакцинированной популяции) продемонстрированы пока только для ПКВ13 (США, Англия и Уэльс, Израиль, Франция, Норвегия).

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