[Antipneumococcal vaccines in sickle-cell anemia and asplenia].

TWO MEANS OF PREVENTION: Asplenic and sickle-cell anemia patients are susceptible to infections caused by polysaccharide-encapsulated bacteria, particularly pneumococci, Haemophilus influenzae b, and meningococci. Prevention of these frequent and serious infections depends on antibiotic prophylaxis and vaccination. ANTI-POLYSACCHARIDE PNEUMOCOCCI: Vaccination Pneumo 23 is a 23-valent vaccine corresponding to more than 90% of the pneumococci strains implicated in systemic infections. The efficacy of conjugated polysaccharide vaccines for the prevention of systemic infections, particularly when caused by antibiotic-resistant strains, can optimize the efficacy potential of antibiotic prophylaxis, the immense majority of strains not covered by the conjugated vaccine being susceptible to penicillin. CONJUGATED PNEUMOCOCCAL VACCINE: Prevenar is a seven-valence vaccine which induces a thymodependent antibody response. The efficacy of the conjugated vaccine against systemic infections, particularly antibiotic resistant strains, can have a potentializing effect on antibiotic prophylaxis, the vast majority of the strains not present in the conjugated vaccine being sensitive to penicillin. OTHER VACCINES: Finally, it should be recalled that conjugated antigroup C meningococcal vaccines are recommended for asplenic and sickle-cell anemia patients. In France, the anti-Haemophilus b vaccine is included in the vaccination calendar for all infants.