Availability of the pneumococcal vaccine for the over 65s

A recent news story has highlighted a case of limited availability of the pneumococcal polysaccharide vaccine (PPV23) which is offered free on the NHS to those at increased risk of disease. 

Meningitis Research Foundation (MRF) is aware that there have been some longstanding supply issues with the vaccine, but health officials are aware and have put special measures in place to distribute the vaccine more effectively to meet UK demand.

GPs have been advised to help ensure demand for vaccine is more consistent across the year by ordering in small quantities to cover the requirements each month. The current policy is therefore to prioritise people who are higher risk and therefore need the vaccine more urgently (see information below).

Because of the relatively short duration of protection, and the increasing incidence with age, there are no major concerns about deferring vaccination in those who are healthy and over 65 year olds for several months or until next year.

About the vaccine

The PPV23 vaccine prevents pneumococcal infection caused by Streptococcus pneumoniae bacteria, and does not protect against viruses.

Older people, and those with some health conditions* are more susceptible to pneumococcal infection.  Pneumococcal infection is the second most common cause of bacterial meningitis and septicaemia in the UK and Ireland and also causes pneumonia and sepsis, as well as less severe illnesses such as ear infections and bronchitis.

Two different vaccines are used in the UK to help prevent pneumococcal infection PPV23 and PCV13:

PPV23

The pneumococcal ‘polysaccharide’ vaccine (PPV23) helps prevent meningitis and other illness caused by 23 strains of pneumococcal bacteria. It is offered to groups considered to be at increased risk: anyone over the age of two with a health condition which puts them at increased risk of pneumococcal infection* and people over the age of 65.

This vaccine has been in shorter supply, particularly during the autumn and winter for a number of years.  Health officials are aware of the availability issues and have put special measures in place to distribute the vaccine more effectively to meet UK demand, especially for higher-risk groups. The vaccine is being prioritised for people with underlying health conditions that put them at highest risk from the illness, so need PPV more urgently.

Healthy people aged 65 and over can then be offered the vaccine during the summer, or when supplies are more freely available. There are no major concerns about deferring vaccination in over 65 year olds for several months or until next year.

PCV13

The pneumococcal ‘conjugate’ vaccine (PCV13) is offered as part of the routine immunisation schedule for babies and protects against 13 of the most common strains of pneumococcal bacteria. There is no shortage of the PCV13 vaccine and the childhood vaccination programme is not affected by the shortage of PPV23.

Public Health England issued advice for GP practices in its Vaccine Updates in October 2017 and October 2019 about how to prioritise vaccine delivery for those who are most at risk from pneumococcal infection as well as other preventative measures to minimise any impact on public health.  The latest Vaccine Update, issued in February 2020 said that limited stocks of one PPV vaccine format are available, and further supplies are expected in May 2020.

* 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).