Vaccines

Pneumococcal Disease

What is Pneumo and what illnesses can it cause?

Pneumo, or Pneumococcal disease, is a major cause of illness and death in Ireland, particularly among the very young, the elderly and those with a weakened immune system1.

Pneumo is caused by a common bacterium, Streptoccocus pneumoniae, which can attack different parts of the body. It can cause illnesses that range from mild to very severe. When pneumococcal bacteria spreads from the nose and throat to ears or sinuses, it generally causes mild infections. When it spreads into other parts of the body, it can lead to severe health problems like pneumonia and meningitis2.

VACCINATION IS RECOMMENDED FOR THOSE AT RISK OF DISEASE AS PART OF THE NATIONAL IMMUNISATION PROGRAMME.

Pneumococcal disease is very serious. Those in the following at risk groups should be vaccinated with Pneumococcal Polysaccharide Vaccine (PPV23)1

EVERYBODY AGED
65 YEARS AND OVER

ALSO THOSE AGED
OVER 2 YEARS WITH;

  • Diabetes
  • Chronic lung, heart, liver, or kidney disease
  • Chronic neurological disease
  • Children aged over 2 years and under 5 years of age with a history of invasive pneumococcal disease
  • Coeliac disease
  • Down Syndrome
  • Cochlear implants or are about to get cochlear implants
  • Immune deficiency because of a disease or treatment, including cancer patients
  • Immune deficiency because of a disease or treatment, including cancer patients
  • HIV infection
  • Absent spleen or a non-functioning spleen
  • CSF leaks, either congenital or complicating skull fractures or neurosurgery
  • Intracranial shunt.

Pneumococcal Immunisation Programme

Adult Pneumococcal Vaccination

Pneumococcal Vaccines which can help protect certain populations against Pneumococcal disease are available through the National PPV23 (Pneumococcal Polysaccharide Vaccine) Immunisation Programme1.

The Vaccine is free of charge for those for whom it is officially recommended such as people over the age of 65 and in identified at-risk groups, such as those with diabetes, heart disease or respiratory conditions.

Outside the childhood immunisation programme, pneumococcal vaccination is usually a single vaccination for those at-risk, but re-vaccination may be required for some people in certain at-risk groups.3

The Vaccine can be received when getting your annual flu vaccination or any other time that you visit your doctor’s surgery.

For patient information, visit www.pneumo.ie

Paediatric Pneumococcal Vaccination

PCV 13 (Pneumococcal conjugate Vaccine) or Prevenar 13 is recommended for the routine vaccination of all children born on or after 1st October 20104. This replaced PCV 7 (Prevenar 7) the pneumococcal conjugate Vaccine introduced into the routine childhood immunisation programme in September 20084.

PCV 13 contains Polysaccharide from 13 of the most common capsular types (1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F and 23F)4.

Children should not get PCV if:

  • They had a serious (life-threatening) allergic reaction to a previous dose or any of its constituents4.

Conditions associated with an increased risk of (IPD) Invasive Pneumococcal Disease5

High risk (Group A) Medium risk (Group B)
Asplenia, hyposplenia (including splenectomy, sickle cell disease, haemoglobinopathies, and coeliac disease)
Cancer patients under hospital supervision
Chronic renal disease or nephrotic syndrome
Cochlear implant candidates and recipients
Complement deficiency (particularly C1-C4)
CSF leaks (congenital or complicating skull fracture or neurosurgery)
Haematopoietic stem-cell transplant
Immunosuppressive conditions (e.g. some B- and T-cell disorders, HIV infection, leukaemia, lymphoma), and those receiving immunosuppressive therapies1 or corticosteroids (see Chapter 3).
Intracranial shunt
Solid organ transplant
Children under 5 years of age following invasive pneumococcal disease
Chronic heart, lung, or liver disease
Diabetes mellitus requiring insulin or oral hypoglycaemic drugs
Down syndrome
Occupational exposure to metal fumes (i.e. welders)
Smokers and alcoholics

1 Individuals with primary immunodeficiency may have a suboptimal response to all Vaccines. Pneumococcal Vaccines are unlikely to be immunogenic in children with primary immune deficiencies involving significant B cell compromise who are receiving regular IVIG replacement therapy. However vaccination should be given as it may have some effect.

For more information please visit https://www.hse.ie/eng/health/immunisation/hcpinfo/guidelines/chapter16.pdf

Pneumococcal immunisation for those at increased risk of IPD (Invasive Pneumococcal Disease)5

  High risk (Group A) Medium risk (Group B)
  PCV1 PPV23 PCV PPV23
6 weeks - <24 months Routine schedule 1 dose at > 2 years of age Routine schedule2 1 dose at > 2 years of age
2 - <5 years If unvaccinated, 2 doses 1 dose > 2 months after PCV If unvaccinated, 1 dose2 1 dose > 2 months after PCV
5 - <18 years If unvaccinated, 1 or 23 doses4 1 dose > 2 months after PCV If unvaccinated, 1 dose 1 dose
18 - <65 years If unvaccinated, 1 or 23 doses4 1 – 25 doses > 2 months after PCV None 2 doses, with 2nd dose at ≥65years, ≥5 years after 1st dose)
≥65 years 1 or 23 doses 1 dose ≥2 months after PCV None 1 dose

1 HSCT recipients require 3 doses at 6, 8 and 12 months post-transplant

2 1 additional dose if had IPD, irrespective of Vaccine history

3 2 doses 2 months apart if response may be blunted e.g. asplenia/ hyposplenia (see Chapter 3)

4 If fully vaccinated with PCV7 give 1 dose of PCV13

5 2 doses 5 years apart if response may be blunted e.g. asplenia/ hyposplenia (see Chapter 3)

For more information please visit https://www.hse.ie/eng/health/immunisation/hcpinfo/guidelines/chapter16.pdf

IE-PNX-00006|Date of preparation: January 2020