:: Introduction to PneumoCarr

Every year, approximately one million children worldwide die from acute respiratory infections caused by the bacterium Streptococcus pneumoniae (pneumococcus) particularly in countries with least access to diagnostic and treatment services. An important recent addition to the tools for combating pneumococcal disease is the pneumococcal conjugate vaccine that is protective already in early infancy. The available pneumococcal conjugate vaccines effectively prevent the most serious forms of pneumococcal disease and reduce nasopharyngeal colonization by the vaccine-type pneumococci. The field of pneumococcal immunization is in the state of change and new conjugate vaccines are expected to be licensed in the coming years. In addition, non-capsular and protein-based pneumococcal vaccines are in the early stages of clinical research.

The pneumococcal vaccine trials that focus on the efficacy of the vaccine in preventing pneumococcal disease are both expensive and time-consuming. In other words, because only some people who are colonized eventually become ill, researchers must study tens of thousands of vaccinated individuals over a long period of time to determine whether the vaccine guards against disease. The current vaccine licensure process is build solely on immunogenicity data, which may lead to decision-making based on insufficient information. These issues complicate the worldwide implementation of life-saving pneumococcal vaccines.

The target of the PneumoCarr project is to establish reduction of nasopharyngeal colonization with pneumococci as part of the licensure process of new pneumococcal vaccines. Based on statistical models of pneumococcal colonization, we aim to develop new guidelines for using “the vaccine efficacy against colonization” (VEcol) as an alternative or additional endpoint in vaccine trials. This would provide a quick and inexpensive method for determining the efficacy and expected effectiveness of new pneumococcal vaccines.

The PneumoCarr project is funded by the Grand Challenges in Global Health grant program (the Bill & Melinda Gates Foundation). The project was launched in the beginning of 2006 and will last until the end of 2011. The consortium consists of nine international institutions and is coordinated by the National Institute for Health and Welfare (THL), Finland (Project director: Helena Käyhty, Prof, PhD; Project coordinator: Birgit Simell, PhD).

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