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British Medical Bulletin 2004 70(1):1-14; doi:10.1093/bmb/ldh021
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Published online 31 August 2004

British Medical Bulletin, Vol. 70 © The British Council 2004; all rights reserved

Bacterial polysaccharide–protein conjugate vaccines

Adam Finn

Institute of Child Health, Department of Clinical Sciences South Bristol, University of Bristol, Bristol, UK

Correspondence to: Adam Finn, Professor of Paediatrics, Institute of Child Health, Level 6, UBHT Education Centre, Upper Maudlin Street, Bristol BS2 8AE, UK. E-mail: adam.finn{at}bristol.ac.uk

Following demonstration that chemical conjugation of polysaccharide antigens to proteins could enhance their immunogenicity in the 1920s, interest in this approach to primary prevention of bacterial infections waned with the development and widespread use of antibiotics. Emergence of resistant bacteria rekindled interest in the late 20th century, which saw extremely rapid development and implementation of several vaccines which are already rapidly changing the epidemiology of childhood infections with Haemophilus influenzae type b, Streptococcus pneumoniae and Neisseria meningitidis. Others such as Group B streptococcus and Salmonella typhi infections may soon follow. However, several important questions about the immunology of these antigens remain unanswered and the long-term implications of reducing or eliminating the circulation of organisms which are more commonly nasopharyngeal commensals than pathogenic invaders are uncertain.


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