Introduction

Pneumococcal vaccination
Pneumococcal vaccination

The pneumococcal vaccine (or 'pneumo jab' or pneumonia vaccine as it's also known) protects against pneumococcal infections.

Pneumococcal infections are caused by the bacterium Streptococcus pneumoniae and can lead to pneumonia, septicaemia (a kind of blood poisoning) and meningitis.

Read more about why the pneumococcal vaccination is needed.

Who should have the pneumococcal vaccine?

A pneumococcal infection can affect anyone. However, some people need the pneumococcal vaccination because they are at higher risk of complications. These include:

  • all children under the age of two
  • adults aged 65 or over
  • children and adults with certain long-term health conditions, such as a serious heart or kidney condition

Read more about who should have the pneumo jab.

How often is the pneumococcal vaccine given?

Babies receive the pneumococcal vaccine as three separate injections, at 2 months, 4 months and 12-13 months.

People over-65 only need a single pneumococcal vaccination which will protect for life. It is not given annually like the flu jab.

People with a long term health condition may need just a single one-off pneumococcal vaccination or five-yearly vaccination depending on their underlying health problem.

Two types of pneumonia vaccine

There are two different types of pneumococcal vaccine:

  • pneumococcal conjugate vaccine (PCV) – this is given to all children under two years old as part of the NHS childhood vaccination programme. It's known by the brand name Prevenar 13.
  • pneumococcal polysaccharide vaccine (PPV) – this is given to people aged 65 and over, and to people at high risk due to long term health conditions

More than 90 different strains of the pneumococcal bacterium have been identified, though only between eight and 10 of them cause the most serious infections.

The childhood vaccine (PCV) protects against 13 strains of the pneumococcal bacterium, while the adult vaccine (PPV) protects against 23 strains.

The pneumococcal vaccine is thought to be around 50 to 70% effective at preventing pneumococcal disease.

Read about how the pneumococcal vaccine works.

Who shouldn't have the pneumo jab?

Occasionally, you or your child may need to delay having the vaccination or avoid it completely:

Vaccine allergy

Tell your GP if you or your child has had a bad reaction to any vaccination in the past. If there's been a confirmed severe allergic reaction, called an anaphylactic reaction,  to the pneumococcal vaccine or any ingredient in the vaccine, it's best to avoid having it. However, if it was only a mild reaction, such as a rash, it is generally safe to have the vaccine.

Unwell with a fever

If you or your child are mildly unwell at the time of the vaccination, it's safe to have the vaccine. However, if you or your child are more seriously ill – for example with a high temperature – it's best to delay the vaccination until after recovery.

Pregnancy and breastfeeding

It's thought to be safe to have the pneumococcal vaccine during pregnancy and while you're breastfeeding. But, as a precaution, if you are pregnant you may want to wait until you have had your baby (unless the benefits of having the vaccine outweigh the risks to your child).

Side effects of the pneumococcal vaccine

Like most vaccines, the childhood and adult versions of the pneumococcal vaccine can sometimes cause mild side effects, including:

  • a mild fever
  • redness at the site of the injection
  • hardness or swelling at the site of the injection

There are no serious side effects listed for either the childhood or adult versions of the vaccine apart from an extremely small risk of serious allergic reaction.

Read more about the side effects of the pneumococcal vaccination.

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Why is it necessary?

Pneumococcal infections, at their worst, can cause permanent severe brain damage, or even kill. They tend to be most serious in children, older people and people with certain long-term health conditions.

That's why these groups are offered a pneumococcal vaccination on the NHS. It's a simple and safe vaccine that can prevent pneumococcal infections.

How are pneumococcal infections spread?

Pneumococcal infections are easily spread by close or prolonged contact with someone who has the infection.

The pneumococcal bacteria are present in tiny droplets that are expelled when an infected person breathes, coughs or sneezes. If you breathe in these droplets, you may 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 they can multiply and cause health problems such as pneumonia.

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 pneumococcal infections

Pneumococcal infections are usually one of the following types:

  • non-invasive pneumococcal infections – these occur outside the major organs and tend to be less serious, such as 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 in Wales and England, there are 5,000 to 6,000 serious pneumococcal infections.  Some of these cases will be fatal.

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Who should have it?

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

  • babies
  • people aged 65 and over
  • anyone between the ages of two and 65 with a long term health condition

Babies and the pneumococcal vaccine 

Babies are routinely vaccinated with the a type of pneumo jab known as the pneumococcal conjugate vaccine (PCV) as part of their childhood vaccination programme. They have three injections usually given at:

  • two months old
  • four months old
  • 13 months old

Adults aged 65 or over and the pneumococcal vaccine

If you are 65 or over you will be offered a type of pneumo jab known as the pneumococcal polysaccharide vaccine (PPV). This one-off vaccination is very effective at protecting you against serious forms of pneumococcal infection.

People with health problems and the pneumococcal vaccine

The PPV pneumo jab is available on the NHS in Wales for all adults form the age of 65, it is also recommended for children and adults aged from two to 64 years old with a long term health condition as they are at a higher risk of developing a pneumococcal infection than the general population. Children up to ten years old who are at high risk may also need a different pneumo vaccine called PCV (because the PPV jab doesn't always work in young children).

You are considered to be at a higher risk of a pneumococcal infection if you have:

  • had your spleen removed, or your spleen does not work properly
  • a long-term respiratory disease, for example, chronic obstructive pulmonary disease (the name for a collection of lung diseases that make it difficult to breathe)
  • heart disease, for example, congenital heart disease (a birth defect that affects the heart)
  • chronic kidney disease
  • chronic liver disease, for example, liver cirrhosis (when healthy tissue in the liver is destroyed and replaced by scar tissue)
  • diabetes
  • a suppressed immune system caused by a health condition such as HIV
  • a suppressed immune system caused by medication such as chemotherapy or steroid tablets
  • a cochlear implant (a small hearing device fitted inside your ear)
  • had cerebrospinal fluid (the clear fluid that surrounds the brain and spine) leaking from its usual position, for example, as the result of an accident or surgery

Older children and adults who are severely immunocompromised should also be offered PCV, such as individuals with leukaemia or genetic conditions affecting their immune system.

If you think you, or your child should have a pneumo vaccine talk to your practice nurse, health visitor or GP for advice.

Booster doses of pneumococcal vaccine

If you are at increased risk of a pneumococcal infection you will be given the PPV vaccination just once and, generally, this will protect you for life.

However, if your spleen does not work properly or if you have a chronic kidney condition, you may need booster doses of PPV every five years. This is because your levels of antibodies against the infection will decrease over time.

What to do if you miss a dose of pneumococcal vaccine

If you or your child has missed a dose of pneumococcal vaccine, speak to your GP about when you can complete the course.

If your child is under the age of one and has missed a dose of the PCV vaccine, they can catch up on the remaining doses they need with two months between each dose.

If your child is over the age of one but under two years old and has missed a dose of the PCV vaccine, they will be given a single dose of the PCV vaccine.

If your child is over the age of two but under five years old and has missed a dose of the PCV vaccine, they may need a single dose of the PCV vaccine. However, this may only be recommended if your child is at high risk of pneumococcal infection.

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How does it work?

There are two types of pneumococcal vaccine available. The type of pneumococcal vaccine you are given depends on your age and health.

The pneumococcal conjugate vaccine (PCV) is used to vaccinate children under the age of two.

The pneumococcal polysaccharide vaccine (PPV) is used to vaccinate adults who are 65 and over, and people at high risk due to chronic health conditions.

Both vaccines are given by injection, usually into the upper arm, although for infants under the age of one, the injection may be given into the thigh.

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

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

The pneumococcal vaccine for babies

The pneumococcal conjugate vaccine (PCV) is recommended for children under the age of two and is offered as part of the childhood vaccination programme.

A newer version of the PCV approved in 2010 protects against 13 strains of pneumococcal bacteria. It's brand name is Prevenar 13.

The pneumo jab for over-65s and people with underlying health problems

The pneumococcal polysaccharide vaccine (PPV) is recommended for adults over the age of 65, as well as children and adults between the ages of two and 64 who are considered to be high risk because of a long-term health condition.

PPV protects against 23 types of pneumococcal bacteria. According to the Health Protection Agency (HPA), this covers virtually all (96%) of the types of pneumococcal bacteria that can cause serious diseases in the UK.

Children at risk of pneumococcal infections can have the PPV vaccine from the age of two onwards. It's thought not to work in children under the age of two.

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Side effects

The pneumococcal vaccine is very safe, although like all vaccinations it has some side effects.

It is not possible to catch a pneumococcal infection from the vaccine, because the vaccine doesn't contain any live bacteria.

Side effects of the pneumococcal vaccine in babies

Mild side effects of the pneumococcal conjugate vaccine (PCV), which is the type of pneumo jab given to babies under two include:

  • decreased appetite
  • a slightly raised temperature
  • irritability
  • redness at the site of the injection
  • hardness or swelling at the site of the injection
  • feeling sleepy
  • not sleeping well

More serious side effects of the baby pneumo jab are rare and include:

Side effects of the pneumococcal vaccine in adults and older children

Mild side effects of the pneumococcal polysaccharide vaccine (PPV) - the type of pneumo jab given to adults and children over the age of two include:

  • mild soreness or hardness at the site of the injection lasting one to three days
  • a slightly raised temperature

There are no serious side effects of the PPV version of the pneumo jab apart from serious allergic reaction.

Allergic reactions to the pneumo jab

Very occasionally, a child or adult may have a serious allergic reaction after either type of pneumococcal vaccination.

Known as an anaphylactic reaction, this can cause life-threatening breathing difficulties and collapse. Anaphylaxis is a serious side effect that happens within minutes of the injection. It's very alarming at the time, but it can be completely treated with adrenaline.

The doctor or nurse giving the vaccine will have been trained to know how to treat anaphylactic reactions and, provided they receive treatment promptly, children and adults make a complete recovery.

Between 1997 and 2003 there were 130 vaccine-related anaphylactic reactions in the UK, making the overall rate one in 900,000 (or slightly more than one in a million). All of these people survived.

If you notice any unusual symptoms in your baby or yourself after being vaccinated, call your GP.

Reporting side effects of the pneumococcal vaccine

The Yellow Card Scheme allows you to report suspected side effects from any type of medicine that you are taking. It's run by a medicines safety watchdog called the Medicines and Healthcare products Regulatory Agency (MHRA). See the Yellow Card Scheme website for more information.

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The information on this page has been adapted by NHS Wales from original content supplied by NHS Choices.
Last Updated: 20/03/2019 09:17:37