What Is Pneumococcal Disease?
Pneumococcal disease is an infection caused by the bacterium Streptococcus pneumoniae. It can lead to:
- Bacteremia (infection of the blood)
- ]]>Middle ear infection]]>
- ]]>Bacterial meningitis]]> (which especially affects children under one year)
Streptococcus pneumoniae is spread through contact with a person who has the disease or who carries the bacteria in his throat. This most often occurs through droplets from the nose or mouth of someone with the infection.
This infection is most common in:
- Infants and young children
- Children in daycare
It also occurs often in people with certain illnesses, such as:
These people are at higher risk of getting the disease. Also, Alaskan Natives, Native Americans, and African Americans are more likely to get the infection.
Symptoms of pneumonia include:
- Shortness of breath
- Chest pain worsened by breathing deeply
- Productive cough
- In infants and young children—fever, cough, rapid breathing, and/or grunting
Symptoms of bacteremia include nonspecific symptoms, such as fever and irritability.
Symptoms of middle ear infection include:
- Pain in the ear
- Red, swollen eardrum
Symptoms of meningitis include:
- High fever
- Stiff and sore neck
- Nausea and vomiting
- Difficulty looking into bright lights
- In infants—slowness or inactivity, irritability, vomiting, and/or poor feeding
Treatment involves antibiotics.
What Is the Pneumococcal Vaccine?
There are two types of pneumococcal vaccines:
- Pneumococcal polysaccharide vaccine (PPSV)—recommended for older children and adults
- Pneumococcal conjugate vaccine (PCV)—approved for infants and toddlers. The PCV13 vaccine, which protects against 13 types of pneumococcal bacteria, is now replacing the PCV7 vaccine.
The vaccines are made from inactivated bacteria. The vaccine is given by injection under the skin or into the muscle.
Who Should Get Vaccinated and When?
PPSV is recommended for all adults 65 years of age or older. It is also recommended for people over the age of two who have certain health problems, including:
- Heart or lung disease
- ]]>Sickle cell disease]]>
- Cerebrospinal fluid leakage
- ]]>Hodgkin's disease]]>
- ]]>Kidney failure]]>
- ]]>Multiple myeloma]]>
- Nephritic syndrome
- ]]>HIV infection or AIDS]]>
- Damaged spleen or no spleen
- Organ transplant
- ]]>Cochlear implants]]>
In addition, people over the age of two who are taking medicines that lower the body's resistance to infection are advised to get PPSV. Finally, Alaskan Natives and certain Native American populations (over age 65) should get the vaccine.
The PCV vaccine is recommended for children under two years of age. The vaccine is given in four doses at 2, 4, 6, and 12-15 months.
PCV, in one dose, is also recommended for children between 24-59 months who have not completed or started the vaccine series. PPSV is recommended to children over the age of 2 years old with certain conditions. Children at high risk include those who take medicines that affect the immune system or have the following conditions:
- Heart, lung, or liver disease
- Sickle cell disease
- HIV infection or AIDS
- Damaged spleen or no spleen
Finally, PCV should be considered for children who:
- Are under three years of age
- Are of Alaskan Native, American Indian, or African American descent
- Attend daycare
The number of doses for these children depends on their age.
What Are the Risks Associated With the Pneumococcal Vaccine?
PPSV is a very safe vaccine. Half of the people who get the vaccine have mild side effects. This may include redness or pain at the injection site. Less than 1% will develop a fever, muscle aches, or more severe local reactions. In rare cases, severe allergic reactions and other serious problems occur. However, developing the disease is much more likely to cause serious problems than getting the vaccine.
For PCV, studies have shown that about 25% of infants have redness, tenderness, or swelling at the injection site. Fever is also a risk. There have also been reports of drowsiness and loss of appetite. Generally, all vaccines can have a very small risk of serious problems.
]]>Acetaminophen]]> (eg, Tylenol) is sometimes given to reduce pain and fever that may occur after getting a vaccine. In infants, the medicine may weaken the vaccine's effectiveness. Discuss the risks and benefits of taking acetaminophen with the doctor.
Who Should Not Get Vaccinated?
The safety of PPSV in pregnant women has not been studied. If you are pregnant, talk to your doctor about the vaccine.
Also, certain children should not get PCV, such as those who have
- Had a life-threatening allergic reaction to a previous dose of PCV
- Had a severe allergy to one of the vaccine's components
Children who have minor illnesses (eg, a ]]>cold]]>) can be vaccinated. Those who are moderately or severely ill should wait until they recover to get the vaccine.
What Other Ways Can Pneumococcal Disease Be Prevented Besides Vaccination?
Avoiding close contact with people who have infections can prevent the disease. Washing your hands regularly can reduce your risk of infection.
What Happens in the Event of an Outbreak?
In the event of an outbreak, all people who are eligible for a vaccine should receive it.
WHERE CAN I GET MORE INFORMATION?
National Immunization Program
Centers for Disease Control and Prevention
Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2009. Ann Intern Med. 2009;150:40-44.
Centers for Disease Control and Prevention. Pneumococcal conjugate vaccine. Centers for Disease and Control and Prevention website. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-pcv.pdf. Update April 16, 2010. Accessed June 11, 2010.
National Immunization Program. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/nip.
Parents’ guide to childhood immunization. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/vpd-vac/pneumo/downloads/pg_why_vacc_pneumo.pdf. Accessed February 18, 2008.
Vaccine information for the public and health professionals—pneumoccocal vaccine: questions and answers. Immunization Action Coalition website. Available at: http://www.vaccineinformation.org/pneumchild/qandavax.asp. Accessed February 18, 2008.
1/31/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years—United States, 2008. MMWR. 2008;57;Q1-Q4. Centers for Disease Control and Prevention, MMWR website. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5701a8.htm. Updated January 10, 2008. Accessed January 28, 2008.
10/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Prymula R, Siegrist C, Chlibek R, et al. Effect of prophylactic paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: two open-label, randomised controlled trials. Lancet. 2009;374(9698):1339.
Last reviewed November 2009 by ]]>David L. Horn, MD, FACP]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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