Yet a number of European countries still only vaccinate selected at-risk groups against IPD, despite growing evidence that universal vaccination of infants and young children reduces their risk and also provides added indirect "herd" protection for other unvaccinated members of the community.

Children in high risk groups include those with underlying medical conditions, such as sickle cell disease, HIV or diabetes.

The general European situation contrasts with the United States, which adopted universal vaccination with the 7-valent pneumococcal conjugate vaccine in August 2000, following the advice of the US Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics.

The CDC recommended vaccinations for infants and children under two years-old, with catch-up vaccinations targeted at children aged two to five years with particular health problems. US authorities also highlighted the need for certain minority and ethnic groups to be added to the list, together with children attending day care.

A European assessment carried out by the authors in August 2005 showed that most countries - Belgium, Germany, Denmark, Finland, the UK, Ireland, Iceland, Norway, Portugal and Sweden - did not offer universal national or regional IPD immunisations, while Austria and France provided the most comprehensive guidelines for vaccinating at-risk groups.

Since then the UK Government has announced that the 7-valent pneumococcal conjugate vaccine will be added to childhood immunisation programmes from this year, pointing out the "immense impact" it has had in the US.

The Netherlands has also announced that the vaccine will be include i
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Contact: Annette Whibley
wordwizard@clara.co.uk
Blackwell Publishing Ltd.
10-Apr-2006