conjugate vaccines


Summary: Semisynthetic vaccines consisting of polysaccharide antigens from microorganisms attached to protein carrier molecules. The carrier protein is recognized by macrophages and T-cells thus enhancing immunity. Conjugate vaccines induce antibody formation in people not responsive to polysaccharide alone, induce higher levels of antibody, and show a booster response on repeated injection.

Top Publications

  1. Theodoratou E, Johnson S, Jhass A, Madhi S, Clark A, Boschi Pinto C, et al. The effect of Haemophilus influenzae type b and pneumococcal conjugate vaccines on childhood pneumonia incidence, severe morbidity and mortality. Int J Epidemiol. 2010;39 Suppl 1:i172-85 pubmed publisher of the literature assessing the effect of Haemophilus influenzae type b (Hib) and pneumococcal (PC) conjugate vaccines on incidence, severe morbidity and mortality from childhood pneumonia...
  2. Fu T, Grimm K, Citron M, Freed D, Fan J, Keller P, et al. Comparative immunogenicity evaluations of influenza A virus M2 peptide as recombinant virus like particle or conjugate vaccines in mice and monkeys. Vaccine. 2009;27:1440-7 pubmed publisher
    ..of these approaches, we constructed two recombinant HBVc VLPs expressing M2 peptide and prepared two conjugate vaccines with M2 peptide chemically coupled to Neisseria meningitidis outer membrane complex (OMPC) or HBVc VLP, ..
  3. Enwere G, Cheung Y, Zaman S, Akano A, Oluwalana C, Brown O, et al. Epidemiology and clinical features of pneumonia according to radiographic findings in Gambian children. Trop Med Int Health. 2007;12:1377-85 pubmed
  4. Eskola J. Foresight in medicine: current challenges with Haemophilus influenzae type b conjugate vaccines. J Intern Med. 2010;267:241-50 pubmed publisher
    ..If we want to take seriously the Millenium Development Goal of reducing the mortality of under 5-year-old children by two-thirds before the year 2015, an effective means to contribute to this would be more efficient use of Hib vaccines...
  5. Madhi S, Adrian P, Kuwanda L, Jassat W, Jones S, Little T, et al. Long-term immunogenicity and efficacy of a 9-valent conjugate pneumococcal vaccine in human immunodeficient virus infected and non-infected children in the absence of a booster dose of vaccine. Vaccine. 2007;25:2451-7 pubmed
    ..2microg/ml to vaccine-serotypes analyzed compared to HIV infected vaccinees at 5.3 years of age. ..
  6. Pace D, Pollard A, Messonier N. Quadrivalent meningococcal conjugate vaccines. Vaccine. 2009;27 Suppl 2:B30-41 pubmed publisher
    ..Monovalent serogroup C conjugate vaccines have become established in the immunisation programmes in many countries and the first quadrivalent ..
  7. Yu S, Gu X. Biological and immunological characteristics of lipooligosaccharide-based conjugate vaccines for serotype C Moraxella catarrhalis. Infect Immun. 2007;75:2974-80 pubmed
    ..These results indicate that the serotype C LOS-based conjugates can be used as vaccine components for further investigation in humans...
  8. Dagan R, Klugman K. Impact of conjugate pneumococcal vaccines on antibiotic resistance. Lancet Infect Dis. 2008;8:785-95 pubmed publisher
    Reduction of drug-resistant Streptococcus pneumoniae (DRSP) by pneumococcal conjugate vaccines (PCVs) has recently become a reality...
  9. Levine O, Knoll M, Jones A, Walker D, Risko N, Gilani Z. Global status of Haemophilus influenzae type b and pneumococcal conjugate vaccines: evidence, policies, and introductions. Curr Opin Infect Dis. 2010;23:236-41 pubmed publisher
    ..Efforts to expand the serotype coverage of pneumococcal vaccines and to monitor the impact of Hib and pneumococcal vaccines and to assure financing obstacles, especially in lower middle-income countries, are required. ..

More Information


  1. Trotter C, McVernon J, Ramsay M, Whitney C, Mulholland E, Goldblatt D, et al. Optimising the use of conjugate vaccines to prevent disease caused by Haemophilus influenzae type b, Neisseria meningitidis and Streptococcus pneumoniae. Vaccine. 2008;26:4434-45 pubmed publisher
    b>Conjugate vaccines exist that offer protection against disease caused by Haemophilus influenzae type b (Hib), and selected serogroups/serotypes of Neisseria meningitidis and Streptococcus pneumoniae...
  2. De Wals P, Erickson L, Poirier B, Pepin J, Pichichero M. How to compare the efficacy of conjugate vaccines to prevent acute otitis media?. Vaccine. 2009;27:2877-83 pubmed publisher
    ..More studies on the current aetiology of AOM need to be performed to accurately predict the marginal benefit of a switch from PCV7-CRM(197) to the newly licensed PCV10-HiD-DiT or to the future PCV13-CRM(197). ..
  3. Lee D, Chun J, Ha H, Park J, Kim B, Oh H, et al. Poly-gamma-d-glutamic acid and protective antigen conjugate vaccines induce functional antibodies against the protective antigen and capsule of Bacillus anthracis in guinea-pigs and rabbits. FEMS Immunol Med Microbiol. 2009;57:165-72 pubmed publisher
    ..anthracis infection, indicating that anti-PGA antibodies play a protective role. Our results demonstrate that PA-PGA conjugate vaccines are effective in the guinea-pig model, in addition to the previously reported mouse model.
  4. Enger K, Stokley S. Meningococcal conjugate vaccine uptake, measured by Michigan's immunization registry. J Adolesc Health. 2007;40:398-404 pubmed
    ..Patterns of immunization were consistent with the Advisory Committee on Immunization Practices (ACIP) recommendations. Coverage of Michigan adolescents is low, but increased in 2005 compared with 2004. ..
  5. Mangtani P, Mulholland K, Madhi S, Edmond K, O Loughlin R, Hajjeh R. Haemophilus influenzae type b disease in HIV-infected children: a review of the disease epidemiology and effectiveness of Hib conjugate vaccines. Vaccine. 2010;28:1677-83 pubmed publisher
    ..Until more definitive evidence is available, physicians may also need to consider a booster dose for such children irrespective of ART status. In any updating of vaccine schedules, HIV-infected children need particular consideration...
  6. Deceuninck G, De Wals P, Boulianne N, De Serres G. Effectiveness of pneumococcal conjugate vaccine using a 2+1 infant schedule in Quebec, Canada. Pediatr Infect Dis J. 2010;29:546-9 pubmed publisher
    ..These results confirm the effectiveness of PCV after 2 and 3 doses. ..
  7. Kweon M. Shigellosis: the current status of vaccine development. Curr Opin Infect Dis. 2008;21:313-8 pubmed publisher
    ..Owing to the wide range of Shigella serotypes and subtypes, there is a need for a multivalent vaccine representing prevalent species and serotypes...
  8. Dziadek S, Jacques S, Bundle D. A novel linker methodology for the synthesis of tailored conjugate vaccines composed of complex carbohydrate antigens and specific TH-cell peptide epitopes. Chemistry. 2008;14:5908-17 pubmed publisher
  9. Shouval D, Greenberg D, Givon Lavi N, Porat N, Dagan R. Serotype coverage of invasive and mucosal pneumococcal disease in Israeli children younger than 3 years by various pneumococcal conjugate vaccines. Pediatr Infect Dis J. 2009;28:277-82 pubmed publisher
    ..Our objective was to assess the potential serotype coverage of PCV7 and of the 2 experimental conjugate vaccines, 10-valent (PCV10) and 13-valent (PCV13), against invasive pneumococcal disease (IPD), acute otitis media (..
  10. Pollard A, Perrett K, Beverley P. Maintaining protection against invasive bacteria with protein-polysaccharide conjugate vaccines. Nat Rev Immunol. 2009;9:213-20 pubmed publisher
    ..The use of protein-polysaccharide conjugate vaccines in developed countries over the past two decades has markedly decreased the burden of disease and mortality ..
  11. Nahas D, Palladino J, Joyce J, Hepler R. Amino acid analysis of peptide loading ratios in conjugate vaccines: a comparison of direct electrochemical detection and 6-aminoquinolyl-N-hydroxysuccinimidyl carbamate pre-column derivatization methods. Bioconjug Chem. 2008;19:322-6 pubmed
    ..Quantitation of these amino acids enabled the determination of the ratio of peptide to protein in the conjugate samples. ..
  12. Saaka M, Okoko B, Kohberger R, Jaffar S, Enwere G, Biney E, et al. Immunogenicity and serotype-specific efficacy of a 9-valent pneumococcal conjugate vaccine (PCV-9) determined during an efficacy trial in The Gambia. Vaccine. 2008;26:3719-26 pubmed publisher
    ..3 microg/ml (95% CI: 1.0, 5.0). The PCV-9 studied was immunogenic in a Gambian population where it was also found to be efficacious. ..
  13. Tozzi A, Azzari C, Bartolozzi G, Esposito S, Fara G, Giudice M. Can hexavalent vaccines be simultaneously administered with pneumococcal or meningococcal conjugate vaccines?. Hum Vaccin. 2007;3:252-9 pubmed
    ..Studies on vaccine coadministration should be promoted and unpublished studies realized for vaccine registration should be made available. ..
  14. Cherian T. WHO expert consultation on serotype composition of pneumococcal conjugate vaccines for use in resource-poor developing countries, 26-27 October 2006, Geneva. Vaccine. 2007;25:6557-64 pubmed
    Pneumococcal conjugate vaccines induce serotype specific protection, with cross-protection seen between serotypes within certain serogroups...
  15. Poolman J, Frasch C, Kayhty H, Lestrate P, Madhi S, Henckaerts I. Evaluation of pneumococcal polysaccharide immunoassays using a 22F adsorption step with serum samples from infants vaccinated with conjugate vaccines. Clin Vaccine Immunol. 2010;17:134-42 pubmed publisher
    ..and included sera from subjects from different geographic areas immunized with different pneumococcal conjugate vaccines, including the licensed 7-valent Prevenar vaccine and the 10-valent Synflorix vaccine...
  16. Masoud H. LPS-based conjugate vaccines composed of saccharide antigens of smooth-type Salmonella enteritidis and rough-type S. gallinarum 9R bound to bovine serum albumin. Scand J Infect Dis. 2007;39:315-22 pubmed
    ..Low in vivo protection was obtained when mice immunized with the conjugates were challenged with 10 times the LD50 of the wild S. enteritidis. ..
  17. Hanage W, Huang S, Lipsitch M, Bishop C, Godoy D, Pelton S, et al. Diversity and antibiotic resistance among nonvaccine serotypes of Streptococcus pneumoniae carriage isolates in the post-heptavalent conjugate vaccine era. J Infect Dis. 2007;195:347-52 pubmed
    ..The clinical significance of this will depend on the pathogenic potential of replacing clones to cause local (e.g., otitis media) or invasive disease. ..
  18. Trotter C, Ramsay M. Vaccination against meningococcal disease in Europe: review and recommendations for the use of conjugate vaccines. FEMS Microbiol Rev. 2007;31:101-7 pubmed
    At the end of 2005, six European countries had implemented public immunization campaigns with serogroup C conjugate vaccines, and all had experienced substantial declines in the incidence of serogroup C disease...
  19. Bliss S, O Brien K, Janoff E, Cotton M, Musoke P, Coovadia H, et al. The evidence for using conjugate vaccines to protect HIV-infected children against pneumococcal disease. Lancet Infect Dis. 2008;8:67-80 pubmed
    Pneumococcal conjugate vaccines (PCVs) are a potentially useful complement to existing treatment strategies in HIV-infected children, for whom pneumococcal infections are common and serious...
  20. Grova N, Prodhomme E, Schellenberger M, Farinelle S, Muller C. Modulation of carcinogen bioavailability by immunisation with benzo[a]pyrene-conjugate vaccines. Vaccine. 2009;27:4142-51 pubmed publisher
    Benzo[a]pyrene (B[a]P) conjugate vaccines based on ovalbumin, tetanus toxoid and diphtheria toxoid (DT) as carrier proteins were developed to investigate the effect of specific antibodies on the bioavailability of this ubiquitous ..
  21. Isaacman D, McIntosh E, Reinert R. Burden of invasive pneumococcal disease and serotype distribution among Streptococcus pneumoniae isolates in young children in Europe: impact of the 7-valent pneumococcal conjugate vaccine and considerations for future conjugate vaccines. Int J Infect Dis. 2010;14:e197-209 pubmed publisher
    ..for PCV7, with mean increases in coverage of 7% and 16% for investigational 10- and 13-valent pneumococcal conjugate vaccines, respectively...
  22. Forsgren A, Riesbeck K, Janson H. Protein D of Haemophilus influenzae: a protective nontypeable H. influenzae antigen and a carrier for pneumococcal conjugate vaccines. Clin Infect Dis. 2008;46:726-31 pubmed publisher
    ..influenzae. This may have great clinical implications, because PD is the first NT H. influenzae antigen that has induced protective responses in humans. ..
  23. Ribeiro G, Lima J, Reis J, Gouveia E, Cordeiro S, Lobo T, et al. Haemophilus influenzae meningitis 5 years after introduction of the Haemophilus influenzae type b conjugate vaccine in Brazil. Vaccine. 2007;25:4420-8 pubmed
    ..influenzae type a clonal groups. These findings indicate that Hib immunization campaign has led to the virtual elimination of Hib disease in this region...
  24. Blanchard Rohner G, Pollard A. Sustaining immunity after immunization against encapsulated bacteria. Hum Vaccin. 2008;4:309-12 pubmed
    ..Over the last 20 years protein-polysaccharide conjugate vaccines have been developed to protect against the major invasive bacterial diseases of childhood, Streptococcus ..
  25. Tsai C, Griffin M, Nuorti J, Grijalva C. Changing epidemiology of pneumococcal meningitis after the introduction of pneumococcal conjugate vaccine in the United States. Clin Infect Dis. 2008;46:1664-72 pubmed publisher
  26. Dagan R, Givon Lavi N, Leibovitz E, Greenberg D, Porat N. Introduction and proliferation of multidrug-resistant Streptococcus pneumoniae serotype 19A clones that cause acute otitis media in an unvaccinated population. J Infect Dis. 2009;199:776-85 pubmed
    ..The introduction and proliferation of multidrug-resistant Sp19A occurred before the introduction of PCV7. The increasing proportion of antibiotic-resistant Sp19A suggests that antibiotic use plays an important role in the community. ..
  27. Timmerman J. Carrier protein conjugate vaccines: the "missing link" to improved antibody and CTL responses?. Hum Vaccin. 2009;5:181-3 pubmed
    ..Could such conjugation strategies be the "missing link" needed in vaccines against pathogens requiring both antibodies and T cells for protection? ..
  28. Vesikari T, Wysocki J, Chevallier B, Karvonen A, Czajka H, Arsène J, et al. Immunogenicity of the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) compared to the licensed 7vCRM vaccine. Pediatr Infect Dis J. 2009;28:S66-76 pubmed publisher
    ..Effective priming is further indicated by robust booster responses. ..
  29. Kubler Kielb J, Vinogradov E, Ben Menachem G, Pozsgay V, Robbins J, Schneerson R. Saccharide/protein conjugate vaccines for Bordetella species: preparation of saccharide, development of new conjugation procedures, and physico-chemical and immunological characterization of the conjugates. Vaccine. 2008;26:3587-93 pubmed publisher
    ..These methodologies can be applied to prepare O-SP-based vaccines against other Gram-negative bacteria. ..
  30. Podda A, Saul A, Arora R, Bhutta Z, Sinha A, Gaind R, et al. Conjugate vaccines for enteric fever: proceedings of a meeting organized in New Delhi, India in 2009. J Infect Dev Ctries. 2010;4:404-11 pubmed
    ..However, stand-alone enteric fever conjugate vaccines would allow more flexibility to immunize different age groups and therefore should be rapidly developed.
  31. Yang H, Madoff L, Guttormsen H, Liu Y, Paoletti L. Recombinant group B streptococcus Beta C protein and a variant with the deletion of its immunoglobulin A-binding site are protective mouse maternal vaccines and effective carriers in conjugate vaccines. Infect Immun. 2007;75:3455-61 pubmed
    ..These results suggest that the rBCP(DeltaIgA) could be used as a carrier to augment the immunogenicity of the CPS while expanding coverage to GBS strains bearing BCP. ..
  32. Auckland C, Gray S, Borrow R, Andrews N, Goldblatt D, Ramsay M, et al. Clinical and immunologic risk factors for meningococcal C conjugate vaccine failure in the United Kingdom. J Infect Dis. 2006;194:1745-52 pubmed
    ..The meningococcal serogroup C conjugate (MCC) vaccine was introduced into the United Kingdom with licensure based on immunogenicity data not efficacy data...
  33. Madhi S, Adrian P, Kuwanda L, Cutland C, Albrich W, Klugman K. Long-term effect of pneumococcal conjugate vaccine on nasopharyngeal colonization by Streptococcus pneumoniae--and associated interactions with Staphylococcus aureus and Haemophilus influenzae colonization--in HIV-Infected and HIV-uninfected children. J Infect Dis. 2007;196:1662-6 pubmed
    ..aureus and colonization by H. influenzae were observed only in HIV-uninfected children, possibly as a result of suboptimal adaptive immunity after previous colonization in HIV-infected children. ..
  34. Lipsitch M, O Neill K, Cordy D, Bugalter B, Trzcinski K, Thompson C, et al. Strain characteristics of Streptococcus pneumoniae carriage and invasive disease isolates during a cluster-randomized clinical trial of the 7-valent pneumococcal conjugate vaccine. J Infect Dis. 2007;196:1221-7 pubmed
    ..If sustained, such patterns provide some cause for optimism that rapid evolution of PCV escape strains with drug resistance or high virulence is unlikely. ..
  35. Hausdorff W, Hoet B, Schuerman L. Do pneumococcal conjugate vaccines provide any cross-protection against serotype 19A?. BMC Pediatr. 2010;10:4 pubmed publisher
    ..It is possible that a modest protective effect may be obscured by the presence of countervailing selection pressures (such as high antibiotic use) that favor an increase in colonization with antibiotic-non-susceptible strains of 19A. ..
  36. Oosterhuis Kafeja F, Beutels P, Van Damme P. Immunogenicity, efficacy, safety and effectiveness of pneumococcal conjugate vaccines (1998-2006). Vaccine. 2007;25:2194-212 pubmed
    ..paper we present an overview of the literature on efficacy and safety trials of the various pneumococcal conjugate vaccines on the market (PCV7) and in development (PCV9, PCV11 and allegedly PCV10 and PCV13), as well as of ..
  37. Prymula R, Schuerman L. 10-valent pneumococcal nontypeable Haemophilus influenzae PD conjugate vaccine: Synflorix. Expert Rev Vaccines. 2009;8:1479-500 pubmed publisher
  38. Dagan R. New insights on pneumococcal disease: what we have learned over the past decade. Vaccine. 2009;27 Suppl 3:C3-5 pubmed publisher
    ..The incidence of vaccine-serotype IPD varies widely in geographically disparate regions, indicating that serotype coverage alone may not accurately predict the impact of proposed pneumococcal conjugate vaccines with additional serotypes.
  39. Lucero M, Nohynek H, Williams G, Tallo V, Simoes E, Lupisan S, et al. Efficacy of an 11-valent pneumococcal conjugate vaccine against radiologically confirmed pneumonia among children less than 2 years of age in the Philippines: a randomized, double-blind, placebo-controlled trial. Pediatr Infect Dis J. 2009;28:455-62 pubmed publisher
    Pneumococcus is a leading cause of childhood pneumonia worldwide. Pneumococcal conjugate vaccines (PCV) have demonstrated efficacy against childhood invasive pneumococcal disease (IPD) and pneumonia in the United States and Africa...
  40. Rivera Olivero I, Blommaart M, Bogaert D, Hermans P, de Waard J. Multiplex PCR reveals a high rate of nasopharyngeal pneumococcal 7-valent conjugate vaccine serotypes co-colonizing indigenous Warao children in Venezuela. J Med Microbiol. 2009;58:584-7 pubmed publisher
  41. Blanchard Rohner G, Snape M, Kelly D, John T, Morant A, Yu L, et al. The magnitude of the antibody and memory B cell responses during priming with a protein-polysaccharide conjugate vaccine in human infants is associated with the persistence of antibody and the intensity of booster response. J Immunol. 2008;180:2165-73 pubmed
    ..These findings suggest that these two parameters are good markers of B cell responses to priming and can be used as predictors of long term humoral immunity induced by glycoconjugate vaccines received in early infancy. ..
  42. Southern J, Gelb D, Andrews N, Waight P, Morris R, Cartwright K, et al. Reactogenicity of meningococcal C conjugate vaccines when administered at the same time as, or a month prior to or after, tetanus and diphtheria booster vaccinations. Hum Vaccin. 2006;2:237-42 pubmed
    ..This single blind study was conducted to address safety concerns regarding coadministration of diphtheria/ tetanus (DT,Td) boosters and meningococcal C conjugate (MCC) vaccines containing diphtheria or tetanus conjugate proteins...
  43. Gatchalian S, Palestroque E, de Vleeschauwer I, Han H, Poolman J, Schuerman L, et al. The development of a new heptavalent diphtheria-tetanus-whole cell pertussis-hepatitis B-Haemophilus influenzae type b-Neisseria meningitidis serogroups A and C vaccine: a randomized dose-ranging trial of the conjugate vaccine components. Int J Infect Dis. 2008;12:278-88 pubmed
  44. Poland G. Prevention of meningococcal disease: current use of polysaccharide and conjugate vaccines. Clin Infect Dis. 2010;50 Suppl 2:S45-53 pubmed publisher
    ..Obstacles to achieving optimal vaccine coverage among adolescents persist, and strategies are needed to address these shortcomings. ..
  45. Baqui A, El Arifeen S, Saha S, Persson L, Zaman K, Gessner B, et al. Effectiveness of Haemophilus influenzae type B conjugate vaccine on prevention of pneumonia and meningitis in Bangladeshi children: a case-control study. Pediatr Infect Dis J. 2007;26:565-71 pubmed
    ..The study documented that significant fractions of pneumonia and meningitis in Bangladeshi children age <2 years can be prevented by the Hib conjugate vaccine. ..
  46. Bermal N, Szenborn L, Chrobot A, Alberto E, Lommel P, Gatchalian S, et al. The 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) coadministered with DTPw-HBV/Hib and poliovirus vaccines: assessment of immunogenicity. Pediatr Infect Dis J. 2009;28:S89-96 pubmed publisher
    ..PHiD-CV was immunogenic against each of the 10 pneumococcal vaccine serotypes when coadministered with DTPw-HBV/Hib and poliovirus vaccines. ..
  47. Lee Y, Kelly D, Yu L, Slack M, Booy R, Heath P, et al. Haemophilus influenzae type b vaccine failure in children is associated with inadequate production of high-quality antibody. Clin Infect Dis. 2008;46:186-92 pubmed publisher
    Despite the excellent immunogenicity of Haemophilus influenzae type b (Hib) conjugate vaccines, breakthrough cases of Hib disease still affect a small proportion of vaccinated children in the United Kingdom...
  48. Spohn G, Guler R, Johansen P, Keller I, Jacobs M, Beck M, et al. A virus-like particle-based vaccine selectively targeting soluble TNF-alpha protects from arthritis without inducing reactivation of latent tuberculosis. J Immunol. 2007;178:7450-7 pubmed
  49. Hausdorff W, Dagan R, Beckers F, Schuerman L. Estimating the direct impact of new conjugate vaccines against invasive pneumococcal disease. Vaccine. 2009;27:7257-69 pubmed publisher
    New pneumococcal conjugate vaccines (PCVs) are now becoming available...
  50. Destefano F, Pfeifer D, Nohynek H. Safety profile of pneumococcal conjugate vaccines: systematic review of pre- and post-licensure data. Bull World Health Organ. 2008;86:373-80 pubmed
    ..We conducted a systematic review of the safety of PCV7 and other pneumococcal conjugate vaccines. A total of 42 studies were included in the review...
  51. Scott J. The preventable burden of pneumococcal disease in the developing world. Vaccine. 2007;25:2398-405 pubmed
    The efficacy of pneumococcal conjugate vaccines (PCV) and their remarkable success in operational use in North America challenge us to define the burden of pneumococcal disease and the likely benefits of PCV use in developing countries...
  52. Temime L, Boelle P, Opatowski L, Guillemot D. Impact of capsular switch on invasive pneumococcal disease incidence in a vaccinated population. PLoS ONE. 2008;3:e3244 pubmed publisher the vaccine is currently increasing along with vaccine coverage worldwide; continued surveillance of pneumococcal populations remains of the utmost importance, in particular during clinical trials of the new conjugate vaccines.
  53. Singleton R, Hennessy T, Bulkow L, Hammitt L, Zulz T, Hurlburt D, et al. Invasive pneumococcal disease caused by nonvaccine serotypes among alaska native children with high levels of 7-valent pneumococcal conjugate vaccine coverage. JAMA. 2007;297:1784-92 pubmed
    ..The demonstration of replacement invasive pneumococcal disease emphasizes the importance of ongoing surveillance and development of expanded valency vaccines. ..
  54. Rodgers G, Arguedas A, Cohen R, Dagan R. Global serotype distribution among Streptococcus pneumoniae isolates causing otitis media in children: potential implications for pneumococcal conjugate vaccines. Vaccine. 2009;27:3802-10 pubmed publisher
  55. Wysocki J, Tejedor J, Grunert D, Konior R, Garcia Sicilia J, Knuf M, et al. Immunogenicity of the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) when coadministered with different neisseria meningitidis serogroup C conjugate vaccines. Pediatr Infect Dis J. 2009;28:S77-88 pubmed publisher
    ..coadministered with other routine pediatric vaccines including different Neisseria meningitidis serogroup C conjugate vaccines. One thousand five hundred forty-eight healthy infants received, according to a balanced (1:1:1:1) ..
  56. Cohen N, Stolarsky Bennun M, Amir Kroll H, Margalit R, Nussbaum G, Cohen Sfady M, et al. Pneumococcal capsular polysaccharide is immunogenic when present on the surface of macrophages and dendritic cells: TLR4 signaling induced by a conjugate vaccine or by lipopolysaccharide is conducive. J Immunol. 2008;180:2409-18 pubmed
    ..from the sequence of the mammalian 60-kDa heat shock protein (hsp60) molecule can serve as a carrier in conjugate vaccines with capsular polysaccharide (CPS) molecules of various bacteria...
  57. Gessner B, Adegbola R. The impact of vaccines on pneumonia: key lessons from Haemophilus influenzae type b conjugate vaccines. Vaccine. 2008;26 Suppl 2:B3-8 pubmed publisher
  58. Schmitt H, Maechler G, Habermehl P, Knuf M, Saenger R, Begg N, et al. Immunogenicity, reactogenicity, and immune memory after primary vaccination with a novel Haemophilus influenzae-Neisseria meningitidis serogroup C conjugate vaccine. Clin Vaccine Immunol. 2007;14:426-34 pubmed
    ..A Hib-MenC-TT conjugate vaccine provides vaccination against two major pathogens in a single injection and is a suitable candidate for use in primary or booster vaccination schedules. ..
  59. Silfverdal S, Ekholm L, Bodin L. Breastfeeding enhances the antibody response to Hib and Pneumococcal serotype 6B and 14 after vaccination with conjugate vaccines. Vaccine. 2007;25:1497-502 pubmed
    ..order to investigate the relationship between breastfeeding and the antibody response after vaccination with conjugate vaccines against Hib and pneumococcal diseases...