Pneumococcal vaccine





Introduction

There are two type of pneumococcal vaccine currently in use:
  • pneumococcal conjugate vaccine (PCV)
  • pneumococcal polysaccharide vaccine (PPV)

Indications

The PCV is given to children as part of their routine immunisations (at 2, 4 and 13 months).

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.