What health conditions increase the risk from pneumococcal infection?
Health conditions which increase the risk of infection include:
- having no spleen, due to injury or disease, or a spleen that does not work properly as in sickle cell disorder, and coeliac disease;
- other immunodeficiency, whether inherited or acquired (e.g. HIV);
- immunosuppression as with cancer therapy or organ transplant;
- chronic disease of the heart, kidney or liver;
- chronic respiratory diseases, including, for example, asthma requiring repeated use of systemic steroids, chronic obstructive pulmonary disease;
- diabetes requiring insulin;
- people with or about to have cochlear implantation or other conditions where leakage of cerebrospinal fluid can occur (but vaccination must not delay cochlear implantation).
What protection is offered to people with ‘at risk’ health conditions?
People with at risk health conditions should be offered vaccination with PCV13, PPV23 or both depending on their age and the type of condition they have.
In general the following applies to people with “at risk” health conditions who are up to date with their routine immunisations:
- Babies should be immunised according to the routine schedule followed by one dose of PPV23 after their second birthday,
- Children diagnosed between 1 to 5 years of age:
- at risk conditions (excluding asplenia, splenic dysfunction and the immunocompromised) should have one dose of PPV23 after their second birthday
- those with asplenia, splenic dysfunction and the immunocompromised should have one dose of PCV13 and one dose of PPV23 after their second birthday (at least two months after immunisation with PCV13)
- People diagnosed beyond 5 years of age:
- at risk conditions (but not severely immunocompromised) should have one dose of PPV23
- those who are severely immunocompromised* should have one dose of PCV13 and one dose of PPV23 at least two months after immunisation with PCV13
“At risk” people with an incomplete or unknown immunisation history, absent or damaged spleen, who are HIV positive, receive bone marrow transplants or have chronic renal disease should seek specialist advice as recommendations in these cases can differ or they may need to be re-immunised at regular intervals.
Children who get severe pneumococcal disease
Any child under age 5 years who gets pneumococcal meningitis or other severe pneumococcal disease will be followed up by their GP or paediatrician, to check whether they have an ‘at-risk’ health condition. These children should be offered PCV even if they have already had it. In some cases, they will be offered PPV also.
What can I do if my child has missed their routine immunisations?
ALL children who are under the age of 2 and have missed their immunisations are entitled to receive PCV13 and are entitled to receive other routine immunisations up to age 10.
Why was it necessary for PCV13 to replace PCV7?
There are over 90 strains of pneumococcal bacteria, but most severe disease is caused by only a handful of these strains. PCV7 was very successful at preventing the seven strains of pneumococcal infection it covered — 959 cases of serious illness and 53 deaths were prevented in the first two and a half years after introduction. However, before PCV7 was introduced, cases of pneumococcal disease caused by vaccine and non-vaccine types were on the rise, and after PCV7 was introduced, non-vaccine types continued to rise. Therefore, the vaccine was upgraded to include an additional six bacterial strains and provide broader protection to children.
Is this vaccine safe for my child?
Vaccine safety is carefully established in clinical trials before being introduced and by close monitoring throughout their use. Experience of using this vaccine in the UK and other countries has shown this vaccine to have an excellent safety record. Clinical trial data from studies involving more than 7000 children indicate that PCV13 has a similar safety profile to PCV7.
For serious life threatening diseases such as meningitis and septicaemia, acquiring immunity through immunisation is a far safer way to protect babies and young children than risking exposure to the diseases.