Pneumococcal disease – immunization

Pneumococcal disease is caused by the bacterium Streptococcus pneumoniae. It can cause milder illnesses such as sinusitis or middle ear infections, but it can also lead to more serious complications, including inflammation of the lungs (pneumonia), inflammation of the brain (meningitis) and blood infection (septicaemia). People in high-risk groups are more likely to become seriously ill or die from pneumococcal disease.

Complications of pneumococcal disease#

Pneumococcal immunization can help prevent a number of serious complications, including:

• Sinusitis – infection of the air spaces in the face, causing pain, a blocked nose, yellow-green nasal mucus and headache
• Middle ear infection – causing ear pain, hearing loss, fever, nausea and vomiting
• Septic arthritis – joint infection causing pain, swelling and reduced movement
• Pneumonia – lung inflammation causing fever, cough, chest pain and breathing problems such as shortness of breath
• Septicaemia – a very serious blood infection causing fever, headache and muscle aches
• Meningitis – inflammation of the brain causing high fever, headache, stiff neck, nausea and vomiting, and sometimes coma. Approximately 30 per cent of cases of pneumococcal meningitis are fatal

Who should be immunized#

Vaccines are available to reduce the risk of pneumococcal disease. Immunization is recommended for babies and young children, for older adults, and for people of any age who have a serious medical risk condition. Some populations are also recommended to be immunized at a younger age because they are at higher risk. Recommendations and funding vary from country to country, so check what applies where you live.

Speak with your doctor about whether you, or your child, are at risk. Serious medical risk conditions include, but are not limited to:

• A weakened immune system – including immune deficiency, HIV infection, people receiving chemotherapy or radiotherapy, transplant recipients, and people with a genetic immune deficiency
• Heart disease
• Lung disease (including people who smoke)
• Kidney disease
• Chronic liver disease
• Diabetes
• No spleen, or a spleen that functions poorly
• Down syndrome
• Cochlear implants
• Shunts in the brain
• Leakage of cerebrospinal fluid from around the spine and brain

Immunization may also be recommended for people who drink alcohol at harmful levels or who were born very prematurely.

Who should not receive the vaccine#

The pneumococcal vaccine should not be given to anyone who has had a serious allergic reaction (anaphylaxis) to any component of the vaccine, or to a previous dose of the vaccine.

Immunization for babies and children#

The childhood schedule generally involves a course of doses in infancy, using a vaccine that protects against 13 strains of pneumococcal bacteria, followed by a booster. A second type of vaccine, which protects against 23 strains, may be given as a booster to older children who are at higher risk.

The exact number and timing of doses depends on the child’s age, health and risk factors, and varies between countries. Babies who were born very prematurely, or who have a medical condition that puts them at high risk, follow a schedule for medically at-risk babies. Catch-up immunizations are available for children who have not received their pneumococcal vaccinations. Immunization can substantially reduce the risk of infection, especially in babies.

Immunization for adults#

Adult immunization is recommended for older adults and for people with certain serious medical risk conditions. Some populations are recommended to be immunized from an earlier age. Speak to your doctor or immunization provider for information about the vaccine, its recommended schedule and any cost.

Pregnancy and pneumococcal immunization#

Immunization against pneumococcal disease is not usually recommended for women who are pregnant or breastfeeding. Women who are at increased risk of pneumococcal infection should be vaccinated before pregnancy, or as soon as possible after giving birth. Speak with your doctor about whether you are at risk and should be immunized.

Pre-immunization checklist#

Before receiving the vaccine, tell your doctor or nurse if you, or your child:

• Are unwell, with a temperature over 38.5 °C
• Are pregnant
• Have allergies to any medications or substances
• Have had a serious reaction to any vaccine
• Have had a serious reaction to any component of the vaccine

Side effects of the vaccine#

Vaccines against pneumococcal disease are effective and safe, although all medicines can have unwanted side effects. Side effects are uncommon and usually mild and temporary, occurring in the first few days after vaccination. They may include:

• Low-grade fever
• Localised pain, redness, itching, swelling or burning at the injection site for one to two days
• Occasionally a small lump (nodule) at the injection site that may last several weeks and needs no treatment

Specific treatment is not usually required.

Managing fever after immunization#

Give extra fluids to drink and do not overdress a child who has a fever. Routine use of paracetamol after vaccination is not recommended, but if fever is present, paracetamol can be given – check the label for the correct dose, or ask your pharmacist, especially when giving paracetamol to children.

Managing injection-site discomfort#

Apply a cold, wet cloth to the injection site. Paracetamol may be used to ease discomfort if needed.

When to seek medical advice#

Serious side effects or allergic reactions to the pneumococcal vaccine are rare. There is a very small risk of a serious allergic reaction (anaphylaxis) with any vaccine, which is why you are advised to stay at the clinic for at least 15 minutes after immunization in case further treatment is needed.

If a side effect after immunization is unexpected, persistent or severe, or if you are worried about yourself or your child after a vaccination, see your doctor or immunization nurse as soon as possible, or go directly to a hospital. It is also important to seek advice if you, or your child, are unwell, as this may be due to another illness rather than the vaccination. You can report side effects following immunization to your doctor or immunization provider.

Immunization and HALO#

The immunizations you may need are decided by your health, age, lifestyle and occupation. Together, these factors are referred to as HALO. Talk to your doctor or immunization provider if you think you, or someone in your care, has health, age, lifestyle or occupation factors that could mean immunization is needed.

Key points#

• Pneumococcal infection can cause milder symptoms such as sinusitis or ear infections
• People in high-risk groups are more likely to become seriously ill or die from pneumococcal disease
• Immunization can substantially reduce the risk of infection, especially in babies
• Vaccines are available to reduce the risk of pneumococcal disease
• Immunization is recommended for people in high-risk groups

Where to get help#