A Trial of a 9-Valent Pneumococcal Conjugate Vaccine in Children with and Those without HIV Infection

This controlled trial involving 39,836 children evaluated the efficacy of a 9-valent pneumococcal conjugate vaccine in South Africa. Vaccination decreased the frequency of invasive pneumococcal disease among both HIV-negative and HIV-positive children and reduced the number of first episodes of radiologically confirmed pneumonia. In children a 9-valent conjugate vaccine prevents invasive disease. Acute respiratory tract infections are a major cause of death in children under the age of five years. 1 Streptococcus pneumoniae, the leading bacterial pathogen, 2 has become increasingly resistant to antibiotics. 3 , 4 Administration of a 7-valent vaccine conjugated to a noncatalytic cross-reacting mutant of diphtheria toxin (CRM197) reduced the incidence of invasive pneumococcal disease in children. 5 The formulation lacks serotypes 1 and 5, which are important causes of invasive pneumococcal disease throughout the world. 6 The efficacy of conjugate vaccine in the prevention of invasive pneumococcal disease among children infected with human immunodeficiency virus (HIV) is unknown. Therefore, we conducted a prospective, . . .