Pneumococcal vaccine

About Pneumococcal disease

Every child suffers from fever and cough at some time or the other; however sometimes these common symptoms may be the signs of something more threatening…Pneumococcal infections. These devastating infections are caused by bacteria/ germs called as Streptococcus pneumoniae. Pneumococcal infections can include a wide range of dangerous conditions like severe middle ear infection, sinusitis, pneumonia, meningitis (infection in the membranes of the brain), and bacteremia (infection in the blood stream).   Children and the elderly are especially prone to these infections.  These infections spread through air and can lead to serious complications. In fact, pneumococcal infections are responsible for the death of at least one million children under the age of five every year, which is more than malaria, AIDS and measles combined. 1

Why is a vaccine required?

Some parents may question whether a vaccine for pneumococcus disease is really needed. But, it is important to remember that children under the age of 2 years are at greatest risk for invasive pneumococcal disease. These can lead to serious complications, lots of suffering and even death.  Another problem is that many antibiotics are sometimes ineffective against this disease due to the emergence of drug-resistant strains. Since prevention is better than trying to cure, immunization may help in giving protection. 3

Who should get the vaccine?

It is horrifying to note that 25% of all child deaths in India are due to pneumonia and 30–40% of pneumonia is caused due to pneumococcal infection.1 Hence, protection by vaccination is the key to reduce these numbers.

PCV should also be given to certain high-risk groups 4 such as:

  • Children who have chronic heart or lung disease.
  • Children with spleen disorders or who have undergone spleen removal
  • Children who have low immunity due to other medical conditions like HIV or cancer or kidney failure
  • Children with sickle cell disease or other haemoglobin disorders.
  • The IAPCOI recommends offering both PCV and PPV 23 to all high-risk children

What is the schedule?  4

  • PCV vaccine is generally given as a continuation of 3 doses.
  • First dose at 6, second at 10, and third at 14 weeks.
  • A booster vaccine is given at age 12 through 15 months.

What if a dose is missed? 4

All three doses are required to confer complete immunity to pneumococcal disease. Sometimes, a dose of the vaccine may be missed due to illness of the baby or other unavoidable reasons. At such times, 1 dose of PCV can be given to all healthy children aged 24 through 59 months to complete their immunization.

If the child is above the age of five years, a single dose of PCV13 may be administered to children aged between 6 -18 years who fall in the high-risk category

How effective is the vaccine?

Only 3 shots can give children the armour of protection against pneumococcal disease when they need it the most. Studies have proven that the PCV reduces invasive pneumococcal disease as well as acute otitis media and pneumonia in children. 5

Does it have any side effects? 6

Like most vaccines, a few mild side-effects like site pain, redness, tenderness, swelling, decreased appetite, irritability, fever etc. are experienced with the PCV too.  These side-effects disappear within a few days and are a small price to pay for long-term protection against the perils of pneumococcal disease. 6

 

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References:

  1. Hum Vaccin Immunother. 2012 Sep 1; 8(9): 1317–1320.
  2. Medicina (B Aires). 2003;63(1):9-14.
  3. Manag Care. 2000 Sep;9(9):49-52, 54, 56-7 passim.
  4. http://www.iapindia.org/files/IAP%20Immunization%20Guide%20Book_2009_2010.pdf
  5. Pediatr Infect Dis J. 2000 Apr;19(4):394-7.
  6. 2013 Oct 25;31(45):5289-95. doi: 10.1016/j.vaccine.2013.08.025