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Immunity to pneumococcal infections is impaired in older people, and current vaccines are poorly protective against pneumococcal disease in this population. Naturally acquired immunity to pneumococcal capsular polysaccharides develops during childhood and is robust in young adults but deteriorates with advanced age. In particular, antibody levels and function are reduced in older people. Pneumococcal vaccines are recommended for people >65 years old. However, the benefits of polysaccharide and protein-conjugated vaccines in this population are small, because of both serotype replacement and incomplete protection against vaccine serotype pneumococcal disease. In this review, we overview the immune mechanisms by which naturally acquired and vaccine-induced pneumococcal capsular polysaccharide immunity declines with age, including altered colonization dynamics, reduced opsonic activity of antibodies (particularly IgM), and impaired mucosal immunity.

Original publication




Journal article


Clin Vaccine Immunol

Publication Date





Streptococcus pneumoniae, aging, colonization, immunization, immunoglobulins, mucosal immunity, pneumococcus, pneumonia, Age Factors, Aged, Aged, 80 and over, Antibodies, Bacterial, Bacterial Capsules, Carrier State, Humans, Immunity, Mucosal, Opsonin Proteins, Pneumococcal Infections, Streptococcus pneumoniae