There are two vaccines available to protect children from pneumococcal disease, a serious infection caused by a bacterium known as Streptococcus pneumoniae. Only one of the vaccines, PCV13, is considered safe for children under the age of 2, This vaccine is important because infants and very young children are at higher risk for several dangerous infections, including pneumonia and bacterial meningitis. Some older children may also need to be treated with PCV13.
The second vaccine, PPSV23, has been available for more than 30 years and is recommended for children two years and older. It protects against 23 types of pneumococcal bacteria.
Here is information about these vaccines to help you make informed decisions about protecting the health of your children as well as your own.
What Is Pneumococcal Disease?
Pneumococcal disease is an infection caused by the bacteria Streptococcus pneumoniae or pneumococcus. People can be infected with the bacteria, or they can carry it in their throat, and not be ill. Those carriers can still spread it, primarily in droplets from their nose or mouth when they breathe, cough, or sneeze.
Depending on what organ or part of the body is infected, pneumococcal disease will cause any of several serious illnesses, including:
- Bacterial meningitis, an infection of the covering of the brain and spinal cord that can lead to confusion, coma, and death as well as other physical effects, such as blindness or paralysis
- Pneumonia, an infection of the lungs that creates cough, fever, and difficulty breathing
- Otitis media, a middle ear infection that can cause pain, swelling, sleeplessness, fever, and irritability
- Bacteremia, a dangerous infection of the blood stream
- Sinus infections
There are more than 6,000 deaths each year in the U.S. as a result of pneumococcal disease. More than half of those deaths are in adults who, according to CDC recommendations, should have been vaccinated.
In children under age 5, infection with the pneumococcus bacteria results in approximately 480 cases of meningitis and 4,000 cases of bacteremia or other invasive infection per year. A major problem in very young children is that the classic symptoms of meningitis and pneumonia are often not present, making the disease hard to recognize.
Are Both Pneumococcal Vaccines Safe?
Both vaccines are safe. As with any medicine there is always the possibility of a serious problem, such as an allergic reaction. But with PCV (the vaccine recommended for young children) and PPSV (the vaccine for adults and older children), the risk of serious harm or death is extremely small.
In studies involving nearly 60,000 doses of the PCV vaccine, there have been no moderate or severe reactions. The mild side effects included:
- Redness, tenderness, or swelling where the shot is given in about one out of every four infants
- Fever higher than 100.4 F in about one out of every three infants
- Fever higher than 102.2 F in about one out of every 50 children
- Occasional incidence of fussiness, drowsiness, or loss of appetite
About one out of every two adults who receive the PPSV vaccine experiences redness or pain where the shot is given. Less than 1% have a more severe reaction, such as a fever or muscle aches.
Who Should Get the Pneumococcal Vaccine and When Should It Be Given?
The PCV7 vaccine that covered seven strains of pneumococcal bacteria, has now been updated to the PCV13 vaccine, which covers 13 strains. A PCV series begun with PCV7 should be completed with PCV13. A single additional dose of PCV13 is recommended for all children 14–59 months who have received an age-appropriate series of PCV7 and for all children 60–71 months with underlying specific medical conditions who have received an age-appropriate series of PCV7.
The PCV vaccine is recommended for the following children:
- All infants younger than 24 months should receive four doses of the vaccine, the first one at 2 months. The next two shots should be given at 4 months and 6 months, with a final booster that should be given at 12 to 15 months. Children who do not get their shot at these times should still get the vaccine. The number of doses and time between doses will depend on the child's age.
- Healthy children ages 2 through 4 years who did not complete the four doses should receive one dose of the vaccine.
The PPSV vaccine is recommended for any adult ages 19 through 64 who smokes or has asthma and anyone ages 2 through 64 who is taking a drug or treatment that affects the body's immune system. Examples would be long-term use of steroids, chemotherapy, or radiation therapy.
In addition, anyone ages 2 through 64 who has one of the following (or similar) health conditions that affect the immune system should be vaccinated with PPSV:
- Hodgkin's disease
- lymphoma or leukemia
- kidney failure
- multiple myeloma
- nephrotic syndrome
- HIV infection or AIDS
- damaged spleen or no spleen
- organ transplant
- heart disease
- lung disease
- sickle cell disease
- leaks of cerebrospinal fluid
- cochlear implant
It's now recommended that adults who are ages 65 and older get both the PCV13 and the PPSV23 vaccine. The timing and sequence of the vaccines will vary depending on what vaccines you may have previously had.
Those who are at high risk and those who were vaccinated before age 65 may need to be revaccinated five years after the first dose.
How Important Is It for an Adult Over Age 65 to Get Vaccinated?
It's very important. If you are over age 65 or have an underlying medical condition that puts you at risk and have not had a pneumococcal vaccination, talk to your doctor and ask to schedule one. According to the National Foundation for Infectious Disease, bacteremia and meningitis caused by invasive pneumococcal disease is responsible for the highest rates of death among the elderly and patients who have underlying medical conditions.
Making sure you and your children get the pneumococcal vaccine can save lives.