Pneumococcal Vaccine

Patient Education

What is pneumococcal disease?

Pneumococcal disease is an infection caused by the bacteria Streptococcus pneumoniae or pneumococcus. Pneumococci are certain bacteria that cause human illnesses including lung infections (pneumococcal pneumonia), brain infections (pneumococcal meningitis), blood infections (bacteremia), and middle ear infections (otitis media). People can be infected with the bacteria, or they can carry it in their throat, and not be ill. Those carriers can still spread it, primarily in droplets from their nose or mouth when they breathe, cough, or sneeze. Depending on what organ or part of the body is infected, the pneumococcal disease will cause any of several serious illnesses, including:

• Bacterial meningitis, an infection of the covering of the brain and spinal cord that can present as fever, headache, and vomiting and lead to confusion, coma, and death as well as other physical effects, such as blindness or paralysis.

• Pneumonia, an infection of the lungs. Pneumococcal lung infection can cause high-grade fever, cough, breathing difficulty, and chest pain.

• Ear Infections: a common bacterial complication of influenza otitis media, a middle ear infection can cause pain, swelling, sleeplessness, fever, and irritability.

• Bacteremia, a dangerous infection of the bloodstream. Patients can present with chills, joint pains, lethargy, and poor alertness.

• Sinus infections

  Lung, brain, and ear infections can potentially cause death if untreated. In those who recover, there may be residual damage after brain infections, like hearing defects. Hence, vaccines against pneumococcus prevent not only the disease but its sequelae as well.

Who gets Pneumococcal disease?

• Infants or young children

• Children with poor immunity, like splenectomised patients, HIV infected children

• Children with chronic heart or lung conditions

• Children with cochlear implants

What is Pneumococcal Vaccine?

For more than 30 years, there has been a vaccine that can safely prevent pneumococcal disease. Currently, there are two types of pneumococcal vaccines available in the market: pneumococcal conjugate vaccine (PCV13 and PCV10) and pneumococcal polysaccharide vaccine (PPSV23). Both differ in their components, mechanisms of action, and age at which they can be administered.

There are 3 Pneumococcal conjugate vaccines available in India, namely Prevenar 13 – PCV, Synflorix – PCV 10 and Pneumosil – PCV 10.

There is one pneumococcal polysaccharide vaccine called PPSV23.

Both are effective in preventing illnesses like brain infection and blood infection. PCV13 also protects against lung infection. PPSV23 vaccine (pneumococcal polysaccharide) cannot be used for the part of the population that is most vulnerable to the disease -- children under age 2 years of age as it is less effective in them.

What do these vaccines contain and how do they act?

Like many other vaccines, the pneumococcal vaccines contain killed bacteria.

Polysaccharide vaccines (PPSV23) are not effective in children younger than 2 years, induce only short term immunity, and repeat doses do not give a “boost” to immunity. On the other hand, the conjugate vaccine (PCV13) is effective in children less than 2 years of age, and repeat doses lead to an increase in immunity against pneumococci.

There are currently four vaccines available in India.

Prevenar 13 – PCV contains 13 varieties of the Pneumococcal virus.

Synflorix – PCV 10 and Pneumosil – PCV 10 contain 10 varieties of the Pneumococcal virus, but each contain different varieties.

PPSV23 is a polysaccharide vaccine and contains 23 kinds of Pneumococcal virus.

How are these vaccines administered? - UPDATE

How are these vaccines administered?

The polysaccharide vaccine (PPSV23) is administered in either muscle or the fatty tissue of the arm.

What is schedule for Pneumococcal vaccines?

Pneumococcal polysaccharide vaccine (PPSV23): The minimum age for PPSV 23 is 2 years. It is not recommended for routine use in healthy individuals. Its use is recommended only for the vaccination of persons with certain high-risk conditions.

Dosing schedule of PPSV23

8 weeks after the last dose of PCV13 to children aged 2 years or older with the following conditions:

• anatomic or functional asplenia (including sickle cell disease)
• HIV infection
• cochlear implant
• cerebrospinal fluid leak.

• An additional dose after 5 years

Can these vaccines be given to pregnant women?

Yes. Pregnancy is not a contraindication to pneumococcal immunization.

Are the pneumococcal vaccines safe in children?

Yes. Both PCV (PCV 10 and PCV 13) and PPSV 23 are very safe. Mild reactions like local pain and soreness at the site of injection may occur, especially with PPSV23. A few people may also have a fever, muscle aches, or more severe local reactions. Rarely, severe allergic reactions may occur.

What are the contraindications to pneumococcal vaccine?

Only prior serious allergic reactions to one dose are contraindications. Those who have an acute illness should wait until resolution to be vaccinated.

Can these vaccines cause pneumococcal disease?

No. Both PPSV 23 and PCV (PCV 10 and PCV 13) contain killed bacteria, which cannot cause pneumococcal disease.