Vaccines help prevent pneumococcal disease, i.e. a specific type of lung infection (pneumonia), which is an illness caused by Streptococcus pneumoniae bacteria. Today, doctors have discovered more than 80 different types of pneumococcus bacteria out of which the vaccine covers 23 of them.
Once the vaccine is injected into the body, it helps in stimulating the body’s typical immune system which produces antibodies to fight directed against the bacteria. This method of fighting directly against a specific microbe is called immunisation because of this pneumococcal vaccination is also called pneumococcal immunisation.
One should note that the vaccine does not protect the human body against pneumonia caused by any other microbes, nor does it protect against bacterial strains that are not included in the vaccine. However, it is reassuring also to note that the vast majority of the 80 different types of bacteria are caused by the 23 serotypes contained in the vaccine.
Presently, there are two kinds of pneumococcal vaccines:
- Pneumococcal conjugate vaccine or PCV13
- Pneumococcal polysaccharide vaccine or PPSV23
Most commonly affected by the pneumococcal disease are young children and older adults who are exposed to severe illness and death.
As recommended by Center for Disease Control (CDC), all children younger than two years old and children of two years or older who have certain medical conditions along with adults of 65 years or older to get PCV13.
Also, it recommends that all adults who are 65 years or older, people aged between two to 64 years old who have some medical issues, and adults who are aged between 19 to 64 years old who smoke cigarettes should get PPSV23 vaccine.
- All children younger than two years old
- People aged between 2 years and older with present medical conditions
- Adults who are 65 years or older
- All adults of 65 years or older
- People aged between 2 years and 64 years old with certain medical conditions
- Adults who are between 19 and 64 years old who smoke cigarettes
Types of Pneumococcal Vaccines
As per the Food and Drug Administration (FDA), there are two pneumococcal vaccines licensed for use:
- Pneumococcal conjugate vaccine (PCV13 or Prevnar 13)
- Pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax23)
To be noted,
‘Conjugate means a type of vaccine that joins a protein to part of the bacteria to improve the protection the vaccine provides.’
‘Polysaccharide means a type of vaccine that is made to look like the surface of certain bacteria to help the body’s build protection against that germ.’
- Pneumococcal Conjugate Vaccine, Prevnar 13:
This vaccine is usually given to kids of age 2, 4, 6, 12 up to 15 months old. Whereas, adults who are in requirement of it gets only a single dose. The vaccine protects against 13 types of pneumococcal bacteria that commonly cause severe infections in both children and adults. Also, it helps in preventing ear infections and pneumonia caused by those 13 types of pneumococcal bacteria.
- Pneumococcal Polysaccharide Vaccine, Pneumovax23:
The vaccine is given as a single dose to people who are prescribed to it. CDC recommends that one or two additional doses can be given to those people who are diagnosed with certain chronic medical conditions. It helps in protecting the body against serious infections which are caused by 23 types of pneumococcal bacteria.
Difference between PCV13 and PPSV23
|– protects the body against 13 different strains of the bacteria||– protects against 23 different strains of pneumococcal bacteria|
|– given four separate doses at different times to children who under two years old||– Only one dose is generally given to anyone over 64|
|– Only one dose is usually given to adults older than 64 or adults older than 19 if they are diagnosed with any immune condition||– Given to anyone who is over 19 and who regularly smokes nicotine products like cigarettes or cigars|
Who should not get these vaccines?
If the person and his/her child have had a life-threatening allergic reaction or have a severe allergy:
Should not get PCV13, if anyone had a history of a life-threatening allergic reaction to any of the following:
- This vaccine dose
- A vaccine called PCV7 (or Prevnar)
- A vaccine which contains diphtheria toxoid (for example, DTaP)
Should not get the vaccine, If anyone who has a severe allergy to any component of PCV13.
If the person and his/her child are not feeling well:
- Anyone diagnosed with mild illness, like cold, can probably get the vaccine. However, anyone with more severe illness should probably wait until they recover.
Kids smaller than two years old should not get a dose of this vaccine. Also, inform the professional who is giving any person or their child a pneumococcal polysaccharide vaccine if:
They had a life-threatening allergic reaction to PPSV23; then they should not get another dose.
They have a severe allergy to any component of PPSV23; then they should not get it.
If the person and his/her child are not feeling well
Anyone diagnosed with mild illness, like cold, can probably get the vaccine. However, anyone with more severe illness should probably wait until they recover.
If the person is pregnant
Presently, there is no evidence that PPSV23 is harmful to a pregnant woman or her baby. However, as a precautionary measure, those who need the vaccine should get it before pregnancy, if possible.
Pneumonia Symptoms & Signs
There are many symptoms and signs of pneumonia, which may vary from person to person. Some might be mild or severe depending on the overall state of health and the type of organism causing the illness.
Severe symptoms include
- chest pain when breathing or coughing,
- labored breathing or shortness of breath,
- coughing up phlegm,
Administration of pneumococcal vaccine
It is usually given to adults as a single injection and is a liquid solution of 0.5 mL which is injected into the muscle (intramuscular or IM), typically deltoid muscle, or under the skin (subcutaneous or SC). The area injected is usually disinfected by rubbing alcohol onto the skin before the injection. In children, the conjugated Prevnar 13 vaccine is injected as a series of four doses.
People vaccinated before the age of 65 should be treated again if five or more years have passed since the first dose and when they are at 65. Anyone with a lack of spleen function (such as in sickle cell disease or after spleen removal), patients with chronic kidney disease, transplant patients, immunosuppressed or immunodeficient people, and others at highest risk of fatal infection, a second dose should be given at least five years after the first dose.
Side effects of pneumococcal vaccine
Generally, people who have taken this vaccine did not have any significant problems with it. However, just like any medicine, there is a chance of side effects with vaccines as well. They are usually mild and fade away on their own, but there is a possibility of severe reactions as well.
Mild Problems w.r.t Pneumococcal Conjugate Vaccine
Reactions where the shot was given includes
- Pain or tenderness
- Loss of appetite
- Fussiness (irritability)
- Feeling tired
Young children who are injected with the pneumococcal conjugate vaccine at the same time as inactivated flu vaccine may be at increased risk for seizures caused by fever. Ask your doctor for more information.
Mild problems due to pneumococcal polysaccharide vaccine
Reactions where the shot was given
- Muscle aches
These problems usually go away within around two days.
Problems after getting the vaccine
- Feels dizzy
- Has ringing in the ears
- Has vision changes
Rarely some people get pain in the shoulder and have difficulty moving the arm where the doctor gave the shot.
Such reactions from a vaccine are infrequent, estimated at 1 in a million doses, and usually, these types of responses will occur within a few minutes to hours post-vaccination.
Just like any medicine, there is a very remote chance of a vaccine causing a severe injury or death.
To increase the pace of the evaluation and access to new pneumococcal vaccines across the developing world, a program called Pneumococcal vaccines Accelerated Development, and Introduction Plan (PneumoADIP) was launched. It is funded by the Global Alliance for Vaccines and Immunisation (GAVI and 30 GAVI countries have expressed their interest in participating in it by 2010. The aim of PneumoADIP is to save 5.4 million children by 2030.
To develop a vaccine against pneumococcus, a pilot called Advance Market Commitment (AMC) was initiated in June 2009. The strategy was to address two of the significant policy challenges. First, the lack of affordable vaccines, and second, insufficiency of commercial incentives which helps to develop vaccines for diseases concentrated focusing the developing countries. As per AMC, donors can make a legally binding guarantee, which secures their purchasing right at an agreed-upon price if a future vaccine is developed. It also reduces the risk of donor government as it eliminates the need for R&D projects that require funding that may never produce a vaccine. If the company is not able to make a vaccine that qualifies the predetermined standards, the taxpayers and the governments spend nothing. AMCs provide funding to ensure the developing countries that the vaccines will be affordable once they are developed.
In May 2017, the Government of India decided to include the pneumococcal conjugate vaccine in its Universal Immunisation Programme.
In the United States, for all children aged 2–23 months and for at-risk children aged 24–59 months in 2000, it was recommended to use a heptavalent pneumococcal conjugate vaccine (PCV 7) (e.g. Prevnar, called Prevenar in some countries). This includes the regular four-dose series which is given at 2, 4, 6, 12–14 months of age.
In February 2010, a vaccine which protects against an additional six serotypes and can be given instead of the original Prevnar was introduced (PCV 13/brand name: Prevnar 13).
One of the brands that give at least 85% protection in those under 55 years of age for five years or longer is Pneumococcal polysaccharide vaccine (PPV, Pneumovax is one brand).
Moreover, it is suggested to get immune to those who are at the highest risk of infection, which includes those who are 65 years or older. As there is a high risk of side effects if the dose is repeated, it is generally advised to get the vaccine as a single lifetime dose. For children under two years old, the standard 23-valent vaccines are ineffective.
If someone is between the age two and 65 when indicated, or at age 65, the guidelines of the American College of Physicians call for the administration of the immunization. If someone received the vaccination before age 60, the directions call for one-time revaccination.
In February 2006, it was announced that the UK government would introduce conjugate vaccination for children aged 2, 4 and 13 months and would also include changes to the immunization programme in general. Later in 2009, use of a ten valent pneumococcal conjugate vaccine was approved by the European Medicines Agency in Europe. The 13 valent pneumococcal vaccines were launched in the routine immunization schedule of the UK in April 2010.
In 2009 and 2011, the 7- and 13-valent pneumococcal conjugate vaccines (PCV7 and PCV13) were introduced respectively into the national Expanded Program on Immunization (EPI) in South Africa. It became the first African country and the first nation in the world with a high HIV prevalence to introduce PCV7 into its routine immunization program.
The invasive pneumococcal disease has fallen substantially in the country following the introduction of PCV7. The overall incidence of IPD declined nearly 70% after PCV introduction among children under two years of age, and rates of IPD caused by bacteria targeted by the vaccine decreased by almost 90%.