Pneumococcal vaccination in the Republic of Ireland
Vaccines against pneumococcal disease
There are currently two vaccines that protect against pneumococcal disease; a 23-type 'polysaccharide' vaccine for people over the age of two and a newer 7-type 'conjugate' vaccine for children aged two months to five years.
23-type polysaccharide vaccine
This vaccine can protect most adults for five years or more against the top 23 disease causing types of pneumococcal infection. However, it does not work in children under two years old and is less effective in people with immune deficiencies and the under-fives.
7-type conjugate vaccine
The newer 7-type 'conjugate' vaccine is similar to the successful Hib and Men C vaccines, which provide stronger, more long-term protection than the plain polysaccharide vaccines, even in babies. This vaccine covers the seven types that cause over 80% of serious pneumococcal disease in Irish and UK children aged 6 months to 2 years and about 75% in the under fives in Europe generally. The routine use of this vaccine in America since June 2000 has established a good safety record and shown that it is effective. It is now also offered routinely in the UK, Australia, Canada, Austria, Italy, Spain and Norway. The current recommendation for pneumococcal vaccination in Ireland
1 is that people (aged two months or over) with the following clinical risk factors should get pneumococcal vaccination appropriate to their age:
- Asplenia or severe dysfunction of the spleen, including surgical splenectomy
- Chronic renal disease or nephrotic syndrome
- Chronic heart, lung or liver disease, including cirrhosis
- Diabetes mellitus
- Sickle cell disease
- Immunodeficiency or immunosuppression due to disease or treatment including HIV infection at all stages
- Patients with CSF leaks, either congenital of complicating skull fracture or neurosurgery
- Patients with, or about to have, cochlear implants2
Patients about to have splenectomy should be vaccinated beforehand if possible: ideally 4 to 6 weeks, but at least 2 weeks before surgery or treatment.
Children who receive the 7-type conjugate vaccine should be offered the 23-type polysaccharide vaccine after their second birthday and at least 2 months after their final dose of 7-type conjugate vaccine.
In addition to the recommendation for people with clinical risk factors, the 23-type vaccine is also recommended for all those aged 65 years and over1.
The Future
The Irish government advisory body, the National Immunisation Advisory Committee (NIAC), have recently recommended the use of the conjugate vaccine against pneumococcal disease.
References
1. Immunisation Advisory Committee Royal College of Physicians of Ireland. Immunisation Guidelines (accessed April 2006)
Page last updated 17.04.07