Introduction
- pneumococcal conjugate vaccine (PCV)
- pneumococcal polysaccharide vaccine (PPV)
Indications
The PPV is offered to all adults over the age of 65 years, to patients with chronic conditions such as COPD and to those who have had a splenectomy (see below).
Groups who should be vaccinated:
- asplenia or splenic dysfunction
- chronic respiratory disease: COPD, bronchiectasis, cystic fibrosis, interstitial lung disease. Asthma is only included if 'it requires the use of oral steroids at a dose sufficient to act as a significant immunosuppressant'
- chronic heart disease: ischaemic heart disease if requiring medication or follow-up, heart failure, congenital heart disease. Controlled hypertension is not an indication for vaccination
- chronic kidney disease
- chronic liver disease: including cirrhosis and chronic hepatitis
- diabetes mellitus if requiring medication
- immunosuppression (either due to disease or treatment). This includes patients with any stage of HIV infection
- cochlear implants
- patients with cerebrospinal fluid leaks
Adults usually require just one dose but those with asplenia, splenic dysfunction or chronic kidney disease need a booster every 5 years.