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Pneumococcal Disease
The pneumococcal bacteria are the most common cause of pneumonia, meningitis, sepsis, sinusitis, and ear infection in children under 2 years.
A pneumococcal vaccine has been available for many years but had not been recommended for children under 2 years old because it was not effective in this age group.

A new pneumococcal conjugate vaccine has recently became available.

This vaccine targets the 7 most common disease-causing types of Pneumococcus.

Pneumococcal Disease is the leading cause of bacterial meningitis (swelling of the brain and spinal cord) of children 5 and younger.

It can also cause severe blood infections (bacteremia) and lung infections (pneumonia).

This is spread to people by droplets of bacteria that are breathed in.

For bacteremia and meningitis fatality per case is 10-20% in infants and up to 80% in elderly people. Pneumococcal infections can be treated with antibiotics but vaccination is becoming an important method of prevention since bacteria resistance to antibiotics is becoming a problem.

There are two types of pneumocoocal vaccines:

1. The Pneumococcal polysaccharide vaccine is recommended for children over 2 years with high risk of disease (lack of spleen, sickle cell disease, nephritic syndrome, CSF leak, and immunosuppression including HIV infection). This vaccine is also recommended for adults 65 years and older, those with chronic diseases, immunocompromization, HIV infection, and those in high-risk occupations. One vaccination is enough but people at very high risk may have a single booster after 5 years. This vaccine is not effective in children under 2 years.

2. The pneumococcal conjugate vaccine is recommended for children <24 months and is given at 2,4,6 and 12-15 months. Unvaccinated children >7 most need fewer boosters. It is recommended to consider vaccinating all children aged 24-59 months as well.

Adverse effects include local reactions (polysaccharide 30-50%, Conjugate 10-20% and fever or muscle aches (polysaccharide <1%, conjugate 5-24%) but there are no severe reactions. For children, the vaccination with the conjugate vaccine (Prevnar) is:

For Healthy children :
Three doses are given in the first year of life followed by one booster in the second year.
Dose 1 at 2 months
Dose 2 at 4 months
Dose 3 at 6 months
Dose 4 at 12-15 months.
(The recommended interval between doses is 4-8weeks)

Vaccination for Healthy Children after 7 months until 9 years of age
Age at first dose
Total number of doses
Dosing information
7-11 months
3
-2 doses 4wks apart
-3rd dose after 12mos old
-3rd dose 2mos after 2nd
12-23 months
2
-2 doses 2mos apart
24mos to 9yrs
1
-1 dose

Pneumococcal Disease links
CDC http://www.cdc.gov/nip/diseases/pneumo/default.htm

vaccineinformation.org/ http://www.vaccineinformation.org/pneumchild/qandadis.asp