VACCINE RESOURCE COMMITTEE
of the Edmonton Zone Medical Staff Association
View Full List of Vaccine Questions Here
Pneumococcal Vaccine Question #1:
Why is this vaccine recommended for younger people?
There any many groups of people at particularly high risk of serious and invasive pneumococcal disease. While these at risk groups include the very young, and the elderly, it is also includes a long list of other younger or middle aged people with medical conditions or environmental or behavioural risk factors for invasive disease. The vaccine can protect all of these groups.
The bacterium Streptococcus pneumoniae is the cause of invasive pneumococcal disease (IPD) such as meningitis or bacteremia, and in addition, it is a common cause of respiratory infections including community acquired pneumonia (CAP) and acute otitis media (AOM).
IPD is most common in the very young, the elderly, and groups at increased risk due to an underlying medical, environmental or living condition.
Bacteremia and meningitis are the most common manifestations of IPD in children 2 years of age and younger. Pneumococci cause 50% of all cases of bacterial meningitis. The case-fatality rate of pneumococcal meningitis is 8% among children and 22% among adults. Permanent neurologic damage is common among survivors.
In 2019, the World Health Organization (WHO) estimated that more than 700,000 deaths among children aged less than 5 years were attributable to pneumococcal disease.
In children less than 5 years of age, the effectiveness of Pneu-C-13 following the completion of recommended schedules has been reported to range from 67% to 96% against IPD (vaccine serotypes) and 20% to 77% against pneumonia. There are currently no efficacy or effectiveness data available for Pneu-C-15 or Pneu-C-20 vaccines, but they are expected to be as good or better based on the increased number of serotpyes covered (i.e. covering 15 or 20 serotypes rather than 13).
Infants born prematurely are associated with a risk of chronic lung disease which can increase the risk of IPD. [ RH1] The first dose of pneumococcal conjugate vaccine should be given at 2 months of age, even if the infant is still hospitalized. Children with chronic lung disease are at high risk of IPD and should be immunized using a 4-dose Pneu-C-20 vaccine schedule (at 2, 4, 6 and 12-15 months of age).
For all other individuals, refer to the Alberta Immunization Manual “Biological Pages” for Pneumococcal 20 valent vaccine available here:
https://www.albertahealthservices.ca/assets/info/hp/cdc/if-hp-cdc-pneu-c20-conjate-vac-bio-pg-07-293.pdf; and the associated information page for patients is here: https://www.albertahealthservices.ca/assets/info/hp/cdc/if-hp-cdc-pneu-c20-conjate-vac-info-sht-07-293-r01.pdf
[ RH1]Can ask Karen/peds experts: any reason this sentence we deleted is necessary or additive? If not, we propose removing it.