Pneumococcal polysaccharide vaccine is a vaccine used to prevent Streptococcus pneumoniae (pneumococcus) infections such as pneumonia and septicaemia.

Indications

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In the UK it is recommended routinely for those over 65, and also for both children and adults in special risk categories:

• Serious breathing problems
• Serious heart conditions
• Severe kidney problems
• Long term liver disease
• Diabetes requiring medication
• Immunosuppression due to disease or treatment (e.g. chemotherapy or radio therapy, long-term steroid use, and problems with the spleen (asplenia), either because the spleen has been removed (splenectomy) or doesn’t work properly, for example, sickle cell disease).

Vaccination schedules

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The 23-valent vaccine (e.g. Pneumovax II®) is only appropriate for adults and usually should only be administered once as subsequent re-injection risks severe local reactions. The exception is where immunity may be lost at a faster rate than normal (e.g. patents with asplenia or nephrotic syndrome) when repeated re-vaccination every 5-10 years is recommended.

Children under the age of 2 years fail to mount an adequate response to the 23-valent adult vaccine, and instead a 7-valent conjugated vaccine (e.g. Prevenar®) must be used. Whilst this covers only 7 strains out of more than more than 90 strains, it is these strains that cause 80% to 90% of cases of severe pneumococcal disease, and it is considered to be nearly 100% effective against these strains.Childhood Pneumococcal Disease - information on the disease and the Prevenar vaccine, from the Victoria State (Australia) government. Includes possible side effects.

Vaccination shedule for children

Age	2-6 months	7-11 months	12-23 months
Conjugated vaccine	3 x monthly dose	2 x monthly dose	2 doses, 2 months apart
	Further dose in second year of life
23-valent vaccine	Then after 2nd birthday single dose of 23-valent

Notes and references

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