Abstract：
Invasive pneumococcal disease (IPD) and pneumococcal pneumonia (PP) represent an important health problem among aging adults and those with certain underlying pathologies and some diseases, especially immunosuppressed and some immunocompetent subjects, who are more susceptible to infections and present greater severity and worse evolution. Among the strategies to prevent IPD and PP, vaccination has its place, although vaccination coverage in this group is lower than desirable. Nowadays, there are 2 vaccines available for adults. Polysacharide vaccine (PPV23), used in patients aged 2 and older since decades ago, includes a greater number of serotypes (23), but it does not generate immune memory, antibody levels decrease with time, causes an immune tolerance phenomenon, and have no effect on nasopharyngeal colonization. PCV13 can be used from children 6 weeks of age to elderly and generates an immune response more powerful than PPV23 against most of the 13 serotypes included in it. In the year 2013 the 16 most directly related to groups of risk of presenting IPD publised a series of vaccine recommendations based on scientific evidence regarding anti-pneumococcal vaccination in adults with underlying pathologies and special conditions. A commitment was made about updating it if new scientific evidence became available. We present an exhaustive revised document focusing mainly in recommendation by age in which some more Scientific Societies have been involved.
摘要：
侵袭性肺炎球菌病（IPD）和肺炎球菌肺炎（PP）是老年人和患有某些潜在病理和某些疾病的人的重要健康问题。特别是免疫抑制和一些有免疫能力的受试者，他们更容易受到感染，表现出更严重和更糟糕的进化。在预防IPD和PP的策略中，疫苗接种有它的位置，尽管该组的疫苗接种覆盖率低于理想水平。如今,有两种疫苗可供成人使用。Polysacharide疫苗（PPV23），自几十年前以来，用于2岁及以上的患者，包括更多的血清型（23），但它不会产生免疫记忆，抗体水平随时间降低,导致免疫耐受现象，对鼻咽定植没有影响.PCV13可以从6周龄的儿童到老年人使用，并且对其中包含的13种血清型中的大多数产生比PPV23更强大的免疫应答。在2013年，与出现IPD的风险群体最直接相关的16项疫苗建议基于关于在具有潜在病理和特殊条件的成年人中进行抗肺炎球菌疫苗接种的科学证据。如果有新的科学证据，则承诺对其进行更新。我们提出了一份详尽的修订文件，主要侧重于按年龄提出的建议，其中涉及更多的科学协会。
