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Pneumococcal

The term pneumococcal disease describes infections caused by the bacterium Streptococcus pneumoniae. Pneumococcal infection causes a broad range of diseases in older people. 

It is the most common cause of serious pneumonia. As well as infecting the lungs, pneumococcal bacteria can infect the blood stream. This type of infection is called invasive pneumococcal disease (IPD). It is responsible for causing the more serious consequences of pneumococcal infection, such as septicaemia (blood poisoning), meningitis or invasive pneumococcal pneumonia, which are more likely to lead to death than non-invasive infections. 

Older people and very young children are most at risk from pneumococcal disease, particularly if they are already ill, have no spleen, or have a weakened immune system, eg if they are having treatment for cancer. The risk in adults increases sharply in those aged 65 and over. 

Vaccination for Babies 

When should my baby be immunised? 

Pneumococcal (PCV) provides some protection against one of the commonest causes of meningitis, and also against other conditions such as severe ear infections (otitis media), and pneumonia caused by pneumococcal bacteria. This vaccine does not protect against all types of pneumococcal bacteria and does not protect against meningitis caused by other bacteria or viruses.  

Your baby should be immunised with their Pneumococcal vaccine (PCV) when they are two and four months old. They will receive the DTaP/IPV/Hib vaccine which protects against five different diseases - diphtheria, tetanus, pertussis (whooping cough), polio and Haemophilus influenzae type b (Hib). 

Booster Dose

A booster dose should of PCV should be given between 12 and 13 months of age at the same time as the child receives their Hib/MenC and MMR vaccinations. This vaccination provides longer-term protection against pneumococcal infection. 

Side Effects

Out of 10 babies immunised your baby might get some of the following side effects, which are usually mild. 

•  Redness, swelling or tenderness where they had the injection.
•  It is quite normal for your baby to be miserable for up to 48 hours after having the injection.
•  Your baby could develop a mild fever.
•  You might notice a small lump where your baby had the injection. This may last for a few weeks but will slowly disappear. 

If you think your baby has had any other reaction to the DTaP/IPV/Hib vaccine and you are concerned about it, talk to your doctor, practice nurse or health visitor. 

Parents and carers can also report suspected side effects of vaccines and medicines through the Yellow Card Scheme. 

You can do this online by visiting www.yellowcard.gov.uk or by calling the Yellow Card hotline on Freephone 0808 100 3352 (available Monday to Friday from 10am to 2pm). 

Aged 65 and over 

Since March 2004 people who are aged 65 and over have been offered this vaccine to help protect against the more serious consequences of pneumococcal infection. 

Do people who had pneumococcal disease need the vaccine? 

People who have had pneumococcal disease in the past should still be vaccinated as there is more than one type of pneumococcal bacterium and they can still become infected with another type. The vaccine protects against all the common types of pneumococcal bacteria. 

When should pneumococcal vaccine be given? 

Pneumococcal vaccine can be given at any time of the year. However for convenience pneumococcal vaccination can be offered at the same time as offering vaccination against influenza. This avoids the need for a second visit by the patient to their general practice. Where offers are not taken up, these could, in the case of pneumococcal vaccination, be offered opportunistically at patients’ future visits to the practice, or the following year. 

It is currently recommended that most adults will only need one dose of pneumococcal polysaccharide vaccine in their lifetime. 

Re-vaccination with pneumococcal polysaccharide vaccine is not normally advised except, every 5 years (refer to Green book for guidance), in people whose antibody levels are likely to have declined more rapidly eg those with no spleen, with splenic dysfunction or with nephrotic syndrome. 

Other Groups 

People under the age of 65 who are at higher risk from pneumococcal disease are already recommended to receive the vaccine. 

These are listed below and further details are given in the Pneumococcal Chapter of the Green Book. 

  • Asplenia or severe dysfunction of the spleen including homozygous sickle cell disease and coeliac syndrome 
  • Chronic renal disease or nephrotic syndrome 
  • Chronic heart disease 
  • Chronic lung disease 
  • Chronic liver disease including cirrhosis 
  • Diabetes mellitus 
  • Immunodeficiency or immunosuppression due to disease or treatment 
  • HIV infection at all stages 
  • People with cochlear implants 

The polysaccharide vaccine (PPV) used in older people is not suitable for use in children under the age of 2 years, as they are not able to make a long-lasting protective immune response to polysaccharide vaccines. A separate pneumococcal conjugate vaccine (PCV) is licensed and available for use in children in this age group who fall into high-risk categories. 

JCVI have recommended that the small number of children under 2 years in the at-risk groups should have pneumococcal conjugate vaccine.

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