Immunisation, Pneumococcal

The pneumococcal vaccination provides protection against pneumococcal infections.

Pneumococcal infections are caused by the bacterium Streptococcus pneumoniae, which is sometimes referred to as the pneumococcus bacterium. There are many different strains (types) of the bacterium that can cause a number of conditions, including:

  • pneumonia - inflammation (infection) of the lungs
  • septicaemia - a form of blood poisoning from an infection in the blood
  • meningitis - an infection of the membranes that surround the brain and spinal cord

At-risk groups

A pneumococcal infection can affect anyone. However, some groups of people have a higher risk of the infection developing into a serious health condition. These include:

  • children who are under two years of age
  • adults who are 65 years of age or over
  • children and adults with certain chronic (long-term) health conditions, such as a serious heart or kidney condition

Types of pneumococcal vaccine

There are two different types of pneumococcal vaccine:

  • pneumococcal conjugate vaccine (PCV): this is given to all children under two years of age as part of the childhood vaccination programme
  • pneumococcal polysaccharide vaccine (PPV): this is given to people who are 65 years of age or over, and people at high risk

See Pneumococcal vaccination - how it works for more information about the two types of vaccine.

Over 90 different strains of the pneumococcal bacterium have been identified, with most serious infections caused by 8-10 strains.

The PCV protects against 13 strains of the pneumococcal bacterium, and the PPV protects against 23 strains.

PPV is thought to be around 50-70% effective at preventing more serious types of pneumococcal disease. 

The pneumococcal vaccination prevents pneumococcal infections, which can lead to very serious health conditions. In some cases, severe pneumococcal infections can lead to death.

How infections spread

Pneumococcal infections are easily spread from person to person, either by close or prolonged contact with someone who has the infection.

The pneumococcal bacteria are present in tiny droplets that are expelled when someone who is infected breathes, coughs or sneezes. If you breathe in these droplets, you will also be infected.

You can also become infected by touching any droplets that might have landed on a surface, such as a table, and then transferring them to your face.

Once the bacteria have entered your body, usually through your nose or throat, they can either lie dormant (which means they do not cause you any harm, but they could still be passed onto someone else), or multiply and cause health problems such as pneumonia (inflammation of the lungs).

For pneumococcal infections, the incubation period (the time between catching an infection and showing symptoms), is thought to be around one to three days.

Types of infections

Pneumococcal infections are usually one of the following two types.

  • Non-invasive pneumococcal infections: these occur outside the major organs and tend to be less serious, for example, otitis media (a middle ear infection).
  • Invasive pneumococcal infections: these occur inside a major organ or in the blood and tend to be more serious, for example, meningitis (an infection of the brain).

Every year hundreds of cases of invasive pneumococcal infections are reported s.

For more information, see the Health A-Z topic on Pneumococcal infections

At-risk groups

Pneumococcal infections are more serious in children, older people and people with certain chronic (long-term) health conditions. This is why these groups of people are offered a pneumococcal vaccination.

There are two different vaccines that protect you against pneumococcal infections. They are:

  • pneumococcal conjugate vaccine (PCV), which is used to vaccinate children who are under two years of age
  • pneumococcal polysaccharide vaccine (PPV), which is used to vaccinate people who are 65 years of age or over, and people at high risk.

Both types of vaccine are given by injection and contain several different strains of pneumococcal bacteria. The vaccine is usually given by injection into the upper arm.

For children up to three years of age, the injection may be given into the upper leg (thigh).

The pneumococcal vaccine encourages your body to produce antibodies against pneumococcal bacteria. Antibodies are proteins that are produced by the body to neutralise or destroy disease-carrying organisms and toxins. The antibodies protect you from becoming ill if you are infected with the bacteria.

The aim of the vaccine is to protect you against most pneumococcal bacteria, although there is no guarantee that you will be immune to all types of the bacteria.

Pneumococcal conjugate vaccine

The pneumococcal conjugate vaccine (PCV) is recommended routinely for all babies as part of the childhood vaccination programme.

Pneumococcal polysaccharide vaccine

The pneumococcal polysaccharide vaccine (PPV) is recommended for all adults who are 65 years of age and older. It is also recommended for all children and adults who are 2-64 years of age and are considered to be at higher risk, for example, because they have a chronic (long-term) health condition.

The PPV provides protection against 23 types of pneumococcal bacteria. This covers 96% of the types of pneumococcal bacteria that can cause serious diseases.

PPV is not given to children under two years of age as it does not work in this age group.

There are three groups of people who need to be vaccinated against pneumococcal infections.

Children

Children are vaccinated with the pneumococcal conjugate vaccine (PCV) as part of their childhood vaccination programme. Three doses of PCV are given at:

  • two months of age
  • six months of age
  • 12 months of age

For more information about the childhood vaccination schedule, see www.immunisation.ie

If your child is under one year of age and has missed a dose of the PCV vaccine, they should receive the remaining doses that they need with two months between each dose.

If your child is over one and under two years of age and has missed a dose of the PCV vaccine, they should be given a single dose of the PCV vaccine. Older children and some adults who are at high risk may also need to have PCV.

High risk groups

It is recommended that children and adults who are 2-64 years of age should have PPV if they are at higher risk of developing a pneumococcal infection than the general population.

You may be at a higher risk if you have:

  • had your spleen (an organ that helps filter your blood) removed, or your spleen does not work properly
  • chronic (long-term) respiratory disease, for example, chronic obstructive pulmonary disease (the name for a collection of lung diseases that make it difficult to breathe)
  • chronic heart disease, for example, congenital heart disease (a birth defect that affects the heart)
  • chronic kidney disease, for example, nephrotic syndrome (when protein leaks from the blood into your urine)
  • chronic liver disease, for example, liver cirrhosis (when healthy tissue in the liver is destroyed and replaced by scar tissue)
  • diabetes (a long-term condition that is caused by too much glucose in the blood) that requires insulin or other medications to lower blood sugar levels
  • a suppressed immune system (the body's defence system) caused by a health condition, such as HIV
  • a suppressed immune system caused by medication such as chemotherapy (a cancer treatment) or steroids (medication that contains powerful chemicals called hormones)
  • a cochlear implant (a small hearing device that can be fitted inside your ear if you have a hearing impairment) 
  • had cerebrospinal fluid (CSF: the clear fluid that surrounds the brain and spine) leaking from its usual position, for example, as the result of an accident or surgery

Adults aged 65 or over

If you are 65 years of age or over you will need to have the pneumococcal polysaccharide vaccine (PPV). This vaccination will protect you against serious forms of pneumococcal infection.

Booster doses

If you are at increased risk of a pneumococcal infection you will be given the PPV just once. In most adults, this is enough to provide protection for life.

A once only booster vaccination may be given:

  • If you are aged 65 years and older and received the vaccine more than 5 years before and were less than 65 years of age at the time of the first dose.
  • If your spleen does not work properly, or if you have a chronic kidney condition, you may need one further booster dose of PPV after five years. This is because your levels of antibodies (proteins that destroy disease-carrying organisms) against the infection will decrease over time.

The pneumococcal vaccinations are considered very safe and rarely cause problems. You cannot catch a pneumococcal infection from the injection because the vaccine does not contain live bacteria.

Pneumococcal conjugate vaccine (PCV)

Possible side effects of the pneumococcal conjugate vaccine (PCV) include:

  • Discomfort, redness and swerlling where the injection was given
  • a slightly raised temperature (mild fever)
  • babies may be irritable

Pneumococcal polysaccharide vaccine (PPV)

Possible side effects of the pneumococcal polysaccharide vaccine (PPV) include:

  • discomfort, redness and swelling where the injection was given
  • a slightly raised temperature (mild fever)

Serious side effects

In very rare cases, people can react badly to the vaccine and develop serious side effects. If you develop any unusual symptoms after having the vaccination, you should call your GP .

Allergic reactions

Before having a pneumococcal vaccination, inform your GP if you have had a bad reaction to any vaccination in the past.

If you have had a confirmed anaphylactic reaction (a severe allergic reaction) to the vaccine, or any ingredient in the vaccine, you should not have it. However, if it was only a mild reaction, it is probably safe for you to have the vaccine. You should discuss this with your GP.

Being unwell

If you have a high temperature (fever), it is likely that the vaccination will be postponed.

Pregnancy and breastfeeding

The pneumococcal vaccine is thought to be safe to have during pregnancy and breastfeeding. As a precaution, if you are pregnant, you may be advised to wait until you have had your baby (unless the benefits of having the vaccine outweigh the risks to your baby).

Suppressed immune system

If you have a suppressed immune system, for example, because you have HIV or AIDS, you may need to have a booster dose of the PPV vaccination. This is because you may not produce enough antibodies (proteins that destroy disease-carrying organisms) to provide immunity after the standard dose of the vaccine. Ask you GP for more information about this.

Content provided by NHS Choices www.nhs.uk and adapted for Ireland by the Health A-Z.

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