What Is Pneumococcal Disease?

Pneumococcal disease is an infection caused by the bacterium Streptococcus pneumoniae . It can lead to:

    
  • Pneumonia
  • Bacteremia (infection of the blood)
  • Bacterial meningitis

    • Streptococcus pneumoniae is spread by person to person contact.

    What Is the Pneumococcal Vaccine?

    There are two types of pneumococcal vaccines:

        
  • Pneumococcal conjugate vaccine (PCV)—recommended for infants and toddlers. The PCV13 vaccine protects against 13 types of pneumococcal bacteria. It replaces the PCV7 vaccine.
  • Pneumococcal polysaccharide vaccine (PPSV)—recommended for certain children and adults

    • The vaccines are made from inactivated bacteria. It is given by injection under the skin or into the muscle. The goal of getting a vaccine is that later, when you are exposed to the bacteria, you will not get sick from it.

    Who Should Get Vaccinated and When?

    PCV

    The PCV is routinely given in four doses at 2, 4, 6, and 12-15 months.

    If your child has not been vaccinated or missed a dose, talk to the doctor. Depending on your child's age, he may need additional doses. Also, an additional dose may be needed if your child:

        
  • Is less than five years old and was given PCV7 (an earlier version of the vaccine)
  • Has a condition that puts him at higher risk for severe disease

    • PPSV

    The PPSV is given to adults aged 65 and older.

    PPSV is also given to anyone aged 2 to 64 who has certain conditions, such as:

        
  • Heart or lung disease
  • Sickle cell disease
  • Diabetes
  • Alcoholism
  • Cirrhosis
  • Cerebrospinal fluid leaks
  • Cochlear implants
  • Hodgkin's disease
  • Lymphoma or leukemia
  • Kidney failure
  • Multiple myeloma
  • Nephrotic syndrome
  • HIV or AIDS or other disease the creates a weak immune system
  • Damaged spleen or no spleen
  • An organ transplant

    • PPSV is also given to anyone aged 2 to 64 who is taking a drug or treatment that lowers the body's ability to resist infection, such as:

        
  • Long-term steroids
  • Certain cancer drugs
  • Radiation therapy

    • The vaccine should be given at least 2 weeks before cancer treatment begins.

    PPSV should also be given to any adult aged 19 to 64 years old who:

        
  • Is a smoker
  • Has asthma
    •     
  • Having certain conditions, such as:
  • Taking medicine that suppresses the immune system

    • In some cases, a second dose of PPSV may be needed. For example, another dose after five years may be needed for people aged 19-64 years who have conditions like chronic renal failure or HIV/AIDS. A second dose is also recommended at age 65 for people who received a dose previously

    What Are the Risks Associated With the Pneumococcal Vaccine?

    PCV

    Side effects include redness, tenderness, or swelling at the injection site. Fever is also a risk. Drowsiness and loss of appetite occur in some children. Fussiness can also occur. Generally, all vaccines have a very small risk of serious problems.

    Acetaminophen (eg, Tylenol) is sometimes given to reduce pain and fever that may occur after getting a vaccine. In infants, the medicine may weaken the vaccine's effectiveness. Discuss the risks and benefits of taking acetaminophen with the doctor.

    PPSV

    Half of the people who get the vaccine have mild side effects. These may include redness or pain at the injection site. Less than 1% will develop a fever, muscle aches, or more severe local reactions. In rare cases, severe allergic reactions and other serious problems occur. However, developing the disease is much more likely to cause serious problems than getting the vaccine.

    Who Should Not Get Vaccinated?

    PCV

    Your child should not receive the PCV if he:

        
  • Had a life-threatening allergic reaction to a previous dose of PCV
  • Had a severe allergy to one of the vaccine's parts
  • Is very ill (wait until your child recovers)

    • PPSV

    You should not receive the PPSV if you:

        
  • Had a life-threatening allergic reaction to a previous dose of PPSV
  • Had a severe allergy to one of the vaccine's components
  • Are very ill (wait until you recover)

    • What Other Ways Can Pneumococcal Disease Be Prevented Besides Vaccination?

        
  • Avoid close contact with people who have infections.
  • Wash your hands regularly to reduce your risk of infection.

    • What Happens in the Event of an Outbreak?

    In the event of an outbreak, all people who are eligible for a vaccine should receive it.

    WHERE CAN I GET MORE INFORMATION?

    American Academy of Family Physicians

    http://familydoctor.org/

    Vaccines & Immunizations

    Centers for Disease Control and Prevention

    http://www.cdc.gov/vaccines/

    References:

    Baker CJ, Pickerling LK, Chilton L, et al; Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2011. Ann Intern Med . 1 Feb 2011. 154(3):168-173.

    Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years —United States, 2012. MMWR 2012;61(5).

    Pneumococcal conjugate vaccine. Centers for Disease and Control and Prevention website. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-pcv.pdf . Update April 16, 2010. Accessed December 12, 2012.

    Pneumococcal polysaccharide vaccine. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-ppv.pdf . Updated October 2009. Accessed December 12, 2012.

    Pneumococcal: understanding the disease. National Network for Immunization Information website. Available at: http://www.immunizationinfo.org/vaccines/pneumococcal-disease . Updated March 31, 2010. Accessed December 12, 2012.

    Recommended adult immunization schedule—United States, 2012. MMWR Morb Mortal Wkly Rep . 2012;6(4). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/schedules/downloads/adult/mmwr-adult-schedule.pdf . Accessed December 12, 2012.

    Vaccine information for the public and health professionals—pneumoccocal vaccine: questions and answers. Immunization Action Coalition website. Available at: http://www.vaccineinformation.org/pneumchild/qandavax.asp . Updated November 2012. Accessed December 12, 2012.

    Vaccine information statement: pneumococcal conjugate vaccine. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-pcv.pdf . Updated April 16, 2010. Accessed December 12, 2012.

    1/31/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years—United States, 2008. MMWR. 2008;57;Q1-Q4. Centers for Disease Control and Prevention, MMWR website. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5701a8.htm . Updated January 10, 2008. Accessed January 28, 2008.

    10/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Prymula R, Siegrist C, Chlibek R, et al. Effect of prophylactic paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: two open-label, randomised controlled trials. Lancet . 2009;374(9698):1339.

    9/17/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Centers for Disease Control and Prevention. Updated recommendations for prevention of invasive pneumococcal disease among adults using the 23-valent pneumococcal polysaccharide vaccine (PPSV23). MMWR Morb Mortal Wkly Rep. 2010;59(34):1102-1106.

    1/7/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance :

    Nuorti J, Whitney C, Centers for Disease Control and Prevention (CDC). Prevention of pneumococcal disease among infants and children—use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine. MMWR Morb Mortal Wkly Rep . 2010;59(34):1102.

    Centers for Disease Control and Prevention (CDC); Advisory Committee on Immunization Practices. Updated recommendations for prevention of invasive pneumococcal disease among adults using the 23-valent pneumococcal polysaccharide vaccine (PPSV23). MMWR Morb Mortal Wkly Rep. 2010;59(34):1102-1106.

    Centers for Disease Control and Prevention (CDC); Advisory Committee on Immunization Practices. Licensure of a 13-Valent pneumococcal conjugate vaccine (PCV13) and recommendations for use among children. MMWR Recomm Rep . 2010;59(RR-11):1.

    Last reviewed December 2012 by Brian Randall, MD

    Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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