Pneumococcal polysaccharide vaccine

Pneumococcal polysaccharide vaccine (PPV), also known as Pneumovax, is a vaccine used to prevent Streptococcus pneumoniae (pneumococcus) infections such as pneumonia and septicaemia. PPV is not the same vaccination as the pneumococcal conjugate vaccine (PCV) that is routinely administered to infants in the US, Canada, and the UK.^[1] See further under Children, below.

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Indications

In the United Kingdom, PPV is recommended (as a part of routine vaccination schedules) for those over the age of 65, and also for both children and adults in special risk categories:

• Serious breathing problems
• Serious heart conditions
• Severe kidney problems
• Long term liver disease
• Diabetes requiring medication
• Immunosuppression due to disease or treatment (e.g. chemotherapy or radio therapy, long-term steroid use, and problems with the spleen (asplenia), either because the spleen has been removed (splenectomy) or does not work properly (for example, due to sickle cell disease).

Vaccination schedule

Adults

The 23-valent vaccine (e.g., Pneumovax II) is only appropriate for adults and usually should only be administered once, as subsequent re-injection risks severe local reactions. The exception is where immunity may be lost at a faster rate than normal (e.g. patients with asplenia or nephrotic syndrome) when repeated re-vaccination every 5-10 years is recommended.

Children

Children under the age of two years fail to mount an adequate response to the 23-valent adult vaccine, and instead a 7-valent Pneumococcal Conjugated Vaccine (PCV) (e.g., Prevnar) must be used. Whilst this covers only seven strains out of more than ninety strains, these seven strains cause 80% to 90% of cases of severe pneumococcal disease, and it is considered to be nearly 100% effective against these strains.^[2]

Special risk-group

Children at special risk (e.g. sickle cell disease and asplenia) require as full protection as can be achieved using the 7-valent congugated vaccine, with then the more extensive 23-valent vaccine given in the second year of life:

Routine childhood vaccination programme

As of 4 September 2006, PCV is also included in the routine childhood vaccination programme for all children in the UK. In those children not at particular risk, PCV is given at 2, 4 and 13 months of age.^[3]

Notes and references

1. ^ Pneumococcal Conjugate Vaccine: What a Parent Needs to Know - information from the American Academy of Family Physicians website - FamilyDoctor.org. Gives statistics of pneumococcal disease incidence and the occurrence rates of various side effects.
2. ^ Childhood Pneumococcal Disease - information on the disease and the Prevnar vaccine, from the Victoria State (Australia) government. Includes possible side effects.
3. ^ Full immunisation schedule. NHS (September 4, 2006).