TABLE OF CONTENTS
- Overview of the Disease
- Types of Pneumococcal Vaccine
- Pneumonia Vaccination Schedule
- Pneumonia Vaccine Side-Effects
- Who Needs the Vaccine?
- Who Shouldn’t Get the Vaccine?
- Vaccine against pneumonia, other then Pneumococcal vaccine
- How Well Do These Vaccines Work?
- Adult Pneumonia Vaccination
- Conclusion
1. Overview of Pneumonia
Pneumococcal disease is caused by a specific type of bacterium called Streptococcus pneumoniae. Pneumococcal disease is most common in children, but it can also occur and cause significant complications in older adults or people with chronic conditions.
The pneumococcal bacterium is contagious and can lead to a variety of conditions. Some of them can be life-threatening. Conditions caused by pneumococcal infections include:
- pneumonia
- meningitis
- sinus infections
- middle ear infections
- bloodstream infections (bacteremia)
It’s important for many people to get vaccinated against pneumococcal disease.
Like all vaccines, the pneumococcal vaccine can have side effects. They’re usually mild and resolve in a few days.
Contact Dr Vinit Mehta now for getting your child vaccinated. Call Now [+918347990180]
Pneumonia-Indian Context
Pneumonia is a leading cause of death in children under 5 years of age (16-25%) in India.
4,10,000 children under 5 years of age die of pneumonia every year. If applied in Indian context, it can be said that 1,23,000 to 1,64,000 under 5 year children die due to pneumococcal pneumonia.
Pneumonia is easily treatable as well as preventable cause of death in children below 5 years of age, yet a child dies from infection every 20 seconds in the world.
Pneumonia in Gujarati:
ન્યુમોનિયા: ફેફ્સા નો ચેપ અથવા સોજો.ન્યુમોનિયાના સૌથી સામાન્ય કારણો બેક્ટેરિયા, વાયરસ અને ફૂગ છે. એમાં S. PNEUMONIAE મુખિયા કારણ છે ન્યુમોનિયા માટે બાળકોમાં, એમાં ભી પેહલાં ૪ થી ૧૨ અઠવાડિયામાં.
Pneumonia in Hindi:
2. Types of Pneumonia Vaccines
Vaccination against a pneumococcal bacterial infection helps prevent you or your child from becoming sick from pneumococcal diseases. It also aids in preventing these diseases from spreading within your community.
Vaccination can’t always prevent all cases of pneumococcal disease. Nevertheless, according to the Centers for Disease Control and Prevention (CDC), even just one doseTrusted Source can help protect against a variety of pneumococcal infections.
Mainly there are 2 types of vaccine: Conjugate & Polysaccharide vaccine
CONJUGATE VACCINES ARE:
PCV13: Prevenar 13 (by Pfizer)
PCV10: Synflorix (by GSK)
PCV10: Pneumosil (by Serum Institute)
POLYSACCHARIDE VACCINE IS:
Pneumovax23 (by MSD)
What to prefer Conjugate or Polysaccharide vaccines?
Conjugate vaccines are preferred over Polysaccharide vaccines because:
- antibody response is generated within 2-4 weeks of immunization after polysaccharide vaccine but it generates predominantly Ig M response with low titers of low affinity Ig G. Thus the half-life of plasma cells is short and antibody titers decline rapidly.
- polysaccharide vaccine are unable to evoke an immune response in those aged less than 2 years due to immaturity of the marginal zones
- as polysaccharide vaccine do not induce germinal centers bonafide, memory B cells are not elicited. Thus repeat exposure of same polysaccharide antigen results in a primary response that follows the same kinetics in previously vaccinated as in naïve individuals.
So it is better to vaccinate your child with conjugate vaccines as they give a life-long immunity to the individual.
PCV13 (pneumococcal conjugate vaccine) Prevanar 13
This vaccine provides protection against 13 strains of pneumococcal bacteria that commonly cause disease in children and adults. It’s given as several doses in children and one dose in adults.
13 strains that are covered are serotypes: 4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F, 3, 6A, 19A
PCV13 is recommended for:
- recommended for all age groups
- people aged 2 to 64 with certain health conditions, such as diabetes mellitus, HIV, or chronic conditions of the heart, kidneys, liver, or lungs
PCV10 (pneumococcal conjugate vaccine) Synflorix
This vaccine provides protection against 10 strains of pneumococcal bacteria that commonly cause disease in children and adults. It’s given as several doses in children.
Serotypes that are covered are: 4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F.
Not present serotypes are 3, 6A & 19A.
PCV10 is recommended for:
- babies
- children aged 2 to 5 years of age who have missed the primary dose, 2 doses 8 weeks apart
PCV10 (pneumococcal conjugate vaccine) Pneumosil
This vaccine provides protection against 10 strains of pneumococcal bacteria that commonly cause disease in children and adults. It’s given as several doses in children.
Serotypes that are covered are: 6B, 9V, 14, 19F, 23F, 1, 5, 7F, 6A, 19A
Not present serotypes are 3, 4 & 18C.
Pneumosil is prepared by Serum Institute of India based on the serotypes of pneumococcal disease prevalent in India. But the vaccine is only approved for India and only for children below 2 years of age.
PCV10 is recommended for:
- babies less than 2 years of age
PPSV23 (pneumococcal polysaccharide vaccine) Pneumovax23
This vaccine defends against 23 strains of pneumococcal bacteria that include serotypes 1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19A, 19F, 20, 22F, 23F & 33F. It’s typically given as one dose. It’s recommended for:
- adults age 65 and older
- people aged 2 to 64 with certain health conditions, such as diabetes mellitus, HIV, or chronic conditions of the heart, kidneys, liver, or lungs
- adults between the ages of 19 and 64 who smoke tobacco products
Vaccine Price
Vaccination price for Prevenar 13, Synflorix, Pneumosil and Pneubevax 14 are provided on vaccination page. [Click here]
3. Pneumonia Vaccine Schedule
Primary Pneumonia Vaccine Schedule
Routine Primary Vaccine schedule for children is a 4 dose schedule. First 3 doses are given one month apart each of them with the first dose at 6 weeks. ie. First dose at 6 weeks (1.5 month); Second dose at 10 weeks (2.5 month) and Third dose at 14weeks (3.5 month). Booster dose is given at 15 months of age.
Other schedule that is followed by Government of India is 3 dose schedule. First dose at 6 weeks (1.5 month), Second dose at 14 weeks (3.5 month) and Booster at 9 months of age. There are several studies done for 4 dose regimen but not many for 3 dose regimen. So 4 dose schedule should be preferred at any cost over 3 dose regimen as followed in many countries as well as backed by several studies & clinical trials. Government of India is following 3 dose regimen in certain 7 states due to cost effectiveness.
Get to know you Baby Vaccination chart for India. Vaccine page.
Follow up Vaccination schedule or Missed Doses
For children who were given no doses of pneumonia vaccine during the first year of life can also be vaccinated with pneumonia vaccine.
Catch-up Schedule:
If child has completed 12 months of age: 2 doses of Synflorix or Prevenar 13 at interval of 8 weeks ( 2 months) apart.
For 2 to 5 years of age: single dose of Prevenar 13 or 2 doses of Synflorix
Child 5 years to adult of any age: single dose of Prevenar 13.
Contact Aashrey Child Clinic, to know more about Pneumonia vaccine. Call Now
FAQ about pneumonia vaccine schedule
Q: Interchangeability of pneumonia vaccine. Can I give Pneumosil vaccine at 10 week, if I have taken Prevenar 13 at 6 week?
A: Can pneumonia vaccine be interchanged between brands? The answer to that is definitely, No. As each brand of conjugate pneumonia vaccine is made for different serotypes and also contain different proteins & adjuvants, so they cannot be used interchangeably. So, always choose the first vaccine very carefully ie considering future costs, availability and total cost with all the vaccines to be given.
Q: Why multiple dose of same Pneumonia vaccine?
A: Although some of the available vaccines can give you immunity after a single dose no matter when you receive it, others have to be given several times at certain ages and intervals to provide full protection. With some diseases your immunity will eventually wear off, and so you will need booster immunizations at intervals to stay fully protected. Because of this, it’s important to keep your child’s (and your own) immunization schedule up to date.
Q: Why are Pneumonia vaccines given at such an early age?
A: Vaccines are given at an early age because the diseases they prevent can strike at an early age. Some diseases are far more serious or common among infants or young children. For example, up to 60% of severe disease caused by pneumonia occurs in children under 12 months of age.
After 2 years, option of single dose of pneumonia vaccine is not preferred as pneumonia is lethal for young children. Commonest cause of death and hospitalization in young children is pneumonia so if you are going for pneumonia vaccine then go for 4 dose regimen as primary schedule not as a single dose catch up schedule.
Q: Any side effects of giving 3 vaccines at one go?
A: No, major side effects have been noted by given pentavalent/ hexavalent, rotavirus vaccine with pneumonia vaccine. Routine side effects that are discussed below are observed with this 3 different vaccines given at the same time.
Q: Does Pneumonia vaccine protect against pneumonia only?
A: Due to marketing, anti-pneumococcal vaccine is branded as pneumonia vaccine. It is efficacious not only against pneumonia but also against meningitis (brain infection), sinusitis, ear infection and bacteremia (blood infection) caused by pneumococcal disease ie Streptococcus pneumoniae. Know more in detail and get you child vaccinated at Aashrey Child Clinic, contact num 8347990180.
Q: Does Pneumonia vaccine protect against all types of Pneumonia?
A: No. Pneumonia conjugate vaccine is protective against only Pneumococcal disease with serotypes 13 or 10 depending on the vaccine selected. Pneumonia is caused by several other bacteria’s, viruses, fungi, chemical and several other reasons so the vaccine is not effective against all the types of pneumonia.
Q: Pneumonia vaccination in Corona pandemic?
A: Pneumonia conjugate vaccine is not directly beneficial for corona affected patients. It does not prevent Corona infection as the vaccine is for an bacterial infection and Coronavirus is an virus. But in Coronavirus infection (SARS CoV-2; Covid-19) majority of patients die due to pneumonia and this pneumonia is commonly due to Streptococcus Pnemoniae so vaccination against Pneumococcal conjugate vaccine can benefit against Corona infection indirectly.
Several viruses like Influenza type A & B, Parainfluenza viruses, Rhinoviruses, Respiratory Syncytial viruses including Coronaviruses are responsible for secondary bacterial infection with Pneumococcal Pneumonia, so it is better to vaccinate with pneumonia vaccination.
Child vaccination in Corona pandemic schedule should be followed according to the primary schedule. Adult if not vaccinated can get vaccinated with pneumonia vaccine for the above indirect benefit.
Also data are available suggesting that PCV 13 vaccinated adults required 35% lower risk of Covid19 diagnosis; 32% lower incidence of Covid 19 hospitalisation and 32% lower incidence of Covid 19 death then adults who didn’t receive the vaccine.
Q: Pneumonia vaccine with Covid vaccines?
A: Yes pneumonia vaccine can be taken before the Corona vaccine and at an interval of 28 days of Covid vaccine. Corona vaccine available in India (Covishield & Covaxin) are inactivated vaccine. But as enough research and clinical trials are not available for these vaccines so difference of 28 days minimum should be kept between pneumonia and corona vaccine (atleast 15 days minimum). Countries with the lowest rates of COVID-19 – Japan, Korea, Denmark, Australia and New Zealand – have the highest rates of pneumococcal vaccination among both infants and adults, according to studies.
4. Pneumonia Vaccine Side-effects
Minor Side effects
What mild side effects may occur?
As with any vaccine, you may experience some mild side effects after receiving the pneumococcal vaccine.
Mild side effects vary depending on which vaccine you receive. They’ll usually go away within a few days.
Possible side effects of the PCV13 vaccine include:
- redness, pain, or swelling at the site of the shot
- mild fever
- chills
- headache
- drowsiness or tiredness
- decreased appetite
- irritability
The possible side effects of the PPSV23 vaccine include:
- redness or pain at the site of the shot
- mild fever
- muscular aches and pains
Sometimes an adult or child can have a serious allergic reaction to the pneumococcal vaccine, but this is very rare.
Allergic reactions to any vaccine are very rare. The CDC estimates they occur in about 1 in 1 millionTrusted Source doses.
Symptoms of a severe allergic reaction typically occur shortly after receiving the vaccine. Severe symptoms can include:
- difficulty breathing
- wheezing
- rapid heartbeat
- feeling lightheaded or as if you may faint
- clammy skin
- anxiety or a feeling of dread
- confusion
If you or your child develops any of these symptoms following vaccination, seek prompt medical attention.
The CDCTrusted Source recommends that babies receive the PCV13 pneumococcal vaccine. This is given in several doses.
On very rare occasions, serious side effects can occur, such as high fever, convulsions, or a skin rash. Contact your child’s pediatrician right away if you notice any of these symptoms.
Problems that Could Happen After Getting Any Injected Vaccine
People sometimes faint after a medical procedure, including vaccination. Sitting or lying down for about 15 minutes can help prevent fainting and injuries caused by a fall. Tell your doctor if you or your child:
-
- Feel dizzy
- Have vision changes
- Have ringing in the ears
- Some people get severe pain in the shoulder and have difficulty moving the arm where the doctor gave the shot. This happens very rarely. Any medicine can cause a severe allergic reaction. Such reactions from a vaccine are very rare, estimated at about 1 in a million shots. These types of reactions would happen within a few minutes to a few hours after the vaccination.
- As with any medicine, there is a very remote chance of a vaccine causing a serious injury or death.
Know about vaccination in detail at Aashrey Child Clinic. Call now: 8347990180.
5. Who needs the Vaccine?
So, let us know who is eligible for the vaccine? Pneumococcal vaccination is recommended for the following groups:
- all infants and children younger than 2 years
- adults over the age of 65
- people who have long-term or chronic health conditions, such as diabetes mellitus or significant cardiovascular disease
- individuals with a weakened immune system
- adults who smoke tobacco products
PCV13
CDC recommends PCV13 for
- All children younger than 2 years old
- People 2 years or older with certain medical conditions
Adults 65 years or older also can discuss and decide, with their doctor, to get PCV13. Contact Dr Vinit Mehta at Aashrey Child Clinic for Prevenar 13 vaccination.
PPSV23
CDC recommends PPSV23 for
- All adults 65 years or older
- People 2 through 64 years old with certain medical conditions
- Adults 19 through 64 years old who smoke cigarettes
Be sure to speak to your doctor about which pneumococcal vaccine is right for you or your child.
Some groups of people shouldn’t receive a pneumococcal vaccination.
The following groups shouldn’t get the PCV13 vaccine:
- individuals who are currently feeling ill
- people who have had a life-threatening allergic reaction to any of the following:
- a previous dose of PCV13
- an earlier pneumococcal vaccine called PCV7
- a vaccine containing the diphtheria toxoid (such as DTaP)
- any components of the PCV13 vaccine
These groups of people shouldn’t receive the PPSV23 vaccine:
- individuals who are currently feeling ill
- pregnant women
- babies below 2 years of age
- people who have had a life-threatening allergic reaction to any of the following:
- a previous dose of PPSV23
- any components of the PPSV23 vaccine
If you’re concerned about an allergic reaction, ask your doctor to provide a list of the vaccine’s components.
7. Vaccine against Pneumonia, other then Pneumococcal Vaccine
We know now that pneumonia is caused by multiple organisms and reasons, so Pneumococcal vaccine is not the only vaccine that can help prevent against pneumonia. Other vaccines that can be beneficial for the baby and can help against prevention of pneumonia are:
Bacterial vaccine: HiB (H. Influenza type b) & Pertussis (whooping cough)
Viral vaccine: Measles, Chicken pox (Varicella) & Influenza (swine flu)
Above are the diseases which can cause pneumonia and are vaccine preventable. To get more information regarding vaccine schedule for above diseases. Click here for Baby Vaccination chart.
8. How well do these Vaccines work?
Some pneumococcal infections are “invasive.” Invasive disease means that germs invade parts of the body that are normally free from germs. Invasive disease is usually very serious and can sometimes result in death.
Vaccines that help protect against pneumococcal disease work well, but cannot prevent all cases.
Studies* show that getting at least 1 shot of PCV13 protects:
- At least 8 in 10 babies from serious infections called invasive pneumococcal disease
- 3 in 4 adults 65 years or older against invasive pneumococcal disease
- 9 in 20 adults 65 years or older against pneumococcal pneumonia
Studies* show that getting 1 shot of PPSV23 protects:
- Between 10 to 17 in 20 healthy adults against invasive pneumococcal disease
* Studies looked at protection against pneumococcal infections caused by the serotypes covered by the specific vaccine used
After introduction of the pneumococcal conjugate vaccine in 2000, several studies described a decrease in invasive pneumococcal disease in the United States. One year after its introduction, a group of investigators found a 69% drop in the rate of invasive disease in those of less than two years of age. By 2004, all-cause pneumonia admission rates had declined by 39% (95% CI 22–52) and rates of hospitalizations for pneumococcal meningitis decreased by 66% (95% CI 56.3-73.5) in children younger than 2.
Rates of invasive pneumococcal disease among adults have also declined since the introduction of the vaccine.
Data Comparsion of PCV 13 with PCV 7- In Depth
The FDA approved the first pneumococcal conjugate vaccine (PCV7) in 2000, offering protection against seven serotypes of pneumococcal bacteria and effectively reducing invasive disease in children. PCV13 got introduced by 2010, covering six additional serotypes and further enhancing immunity. Studies confirm that PCV13 stimulates antibody production, offering similar benefits as PCV7, including reductions in ear infections, pneumonia, and antibiotic-resistant infections.
The U.S. observed significant drops in pneumococcal disease rates after routine PCV use, with PCV7 reducing cases by 99%. PCV13 later prevented thousands of cases and deaths. In 2011, PCV13 was licensed for adults, showing strong efficacy against invasive pneumococcal disease. The polysaccharide vaccine PPSV23 also provides substantial protection for adults with healthy immune systems, covering additional serotypes and reducing severe infections.
9. Adult Pneumonia Vaccination
Just like in young infants, pneumonia is common cause of death in elderly. In this Corona pandemic, we have seen several adults dying due to pneumonia.
Streptococcus Pneumoniae is the commonest cause of Pneumonia in elderly after viral infections like Influenza type A & B, Parainfluenza viruses, Rhinoviruses, Respiratory Syncytial viruses including Coronaviruses. After this viral infection in adults, Streptococcal Pneumonia is the commonest secondary infection leading to death so it is better to vaccinate with Pneumococcal Pneumonia vaccine to protect elderly.
Also data are available suggesting that PCV 13 vaccinated adults required 35% lower risk of Covid19 diagnosis; 32% lower incidence of Covid 19 hospitalisation and 32% lower incidence of Covid 19 death then adults who didn’t receive the vaccine.
Countries with the lowest rates of COVID-19 – Japan, Korea, Denmark, Australia and New Zealand – have the highest rates of pneumococcal vaccination among both infants and adults, according to studies.
The latest Government of India guidelines (June 2021) now approve PCV13 (Prevenar 13 by Pfizer) for all age groups. Previously, it was only available for children and those over 65, but it’s now authorized for individuals aged 19 to 65 as well. A single dose of PCV13 provides adults with protection against pneumococcal disease.
Pneumococcal Vaccine Timing for Adults
Make sure your patients are up to date with pneumococcal vaccination.
Two pneumococcal vaccines are recommended for adults:
- 13-valent pneumococcal conjugate vaccine (PCV13, Prevnar13®)
- 23-valent pneumococcal polysaccharide vaccine (PPSV23, Pneumovax®23)
At Aashrey Child Clinic, adult vaccination is also done. Call Dr Vinit Mehta at 8347990180.
PCV13 and PPSV23
Do not administer both vaccines during the same office visit. When both are indicated, prioritize giving PCV13 before PPSV23 if possible. If either vaccine is given earlier than the recommended timeframe, avoid repeating the dose.
One dose of PCV13 is recommended for adults:
- 19 years or older with certain medical conditions and who have not previously received See Table 1 for specific guidance.
- Adults 65 years or older can discuss and decide, with their clinician, to receive PCV13 if they have not previously received a dose (shared clinical decision-making).
One dose of PPSV23 is recommended for adults:
- 65 years or older, regardless of previous history of vaccination with pneumococcal vaccines.
- Once a dose of PPSV23 is given at age 65 years or older, no additional doses of PPSV23 should be
- 19 through 64 years with certain medical
- A second dose may be indicated depending on the medical See Table 1 for specific guidance.
What’s the difference between PCV 13 & PPSV23?
You’ll likely receive one of two pneumonia vaccines: pneumococcal conjugate vaccine (PCV13 or Prevnar 13) or pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax 23).
| PCV13 | PPSV23 |
| helps protect you against 13 different strains of pneumococcal bacteria | helps protect you against 23 different strains of pneumococcal bacteria |
| usually given four separate times to children under two | generally given once to anyone over 64 |
| generally given only once to adults older than 64 or adults older than 19 if they have an immune condition | given to anyone over 19 who regularly smokes nicotine products like cigarettes (standard or electronic) or cigars |
Some other things to keep in mind:
- Both vaccines help prevent pneumococcal complications like bacteremia and meningitis.
- You’ll need more than one pneumonia shot during your lifetime. A 2016 studyTrusted Source found that, if you’re over 64, receiving both the PCV13 shot and the PPSV23 shot provide the best protection against all the strains of bacteria that cause pneumonia.
- Don’t get the shots too close together. You’ll need to wait about a year in between each shot.
Adults 65 years or older without an immunocompromising condition, CSF* leak, or cochlear implant
Pneumococcal vaccine timing for adults with certain medical conditions
If the patient and provider agree, based on shared clinical decision-making, to administer PCV13 at age 65 or older:
Administer 1 dose of PPSV23 at 19 through 64
Administer 1 dose of PCV13 at 65 years or older. This dose should be given at least 1 year after
Administer 1 final dose of PPSV23 at 65 years or older. This dose should be given at least 1 year after PCV13 and at least 5 years after the most recent dose of
Includes adults with: chronic heart, lung, or liver disease diabetes mellitus alcoholism Also includes adults who smoke cigarettes
Indicated to receive 1 dose of PCV13 at ≥ 19 years and 1 or 2 doses of PPSV23 at 19 through 64 years
Includes adults with:
- cerebrospinal fluid (CSF) leaks*
- cochlear implants*
- sickle cell disease or other hemoglobinopathies
- congenital or acquired asplenia
- congenital or acquired immunodeficiencies
- HIV infection
- chronic renal failure
- nephrotic syndrome
- leukemia
- lymphoma
- Hodgkin disease
- generalized malignancy
- iatrogenic immunosuppression
- solid organ transplant
- multiple myeloma
For those who have not received any pneumococcal vaccines, or those with unknown vaccination history:
- Administer 1 dose of
- Administer 1 dose of PPSV23 at least 8 weeks
- Administer the second dose of PPSV23 at least five years after the previous dose. However, skip this second dose for individuals with CSF leaks or cochlear implants.
- Administer 1 final dose of PPSV23 at 65 years or older. Give this dose at least five years after the most recent PPSV23 dose.
Additional Scenarios
3. Adults recommended to receive PCV13 at ≥ 19 years who already received 2 doses of PPSV23 and 1 dose of PCV13 at < 65 years.
4. Adults recommended to receive PCV13 at ≥ 19 years who already received 2 doses of PPSV23 at < 65 years and 1 dose of PCV13 at ≥ 65 years.
- For those who have already received 1 or more doses of PPSV23, or those with unclear documentation of the type of pneumococcal vaccine received:
-
- First, give one dose of PCV13, ensuring at least a one-year interval after any prior pneumococcal vaccine.
- Next, administer a second dose of PPSV23, at least eight weeks following PCV13 and five years after the previous PPSV23 dose. Note that a second PPSV23 dose is unnecessary for individuals with CSF leaks or cochlear implants.
- Finally, for individuals aged 65 or older, provide a last dose of PPSV23, making sure there is a minimum five-year gap since the last PPSV23 dose.
- For those who have already received 1 dose of PCV13, do not administer an additional dose at 65 years or older.
10. Conclusion
Pneumococcal disease can potentially cause life-threatening illnesses in children, older adults, and people with chronic conditions.
Be sure to talk to your doctor about which pneumococcal vaccine is appropriate for you or your child. Contact Dr Vinit Mehta at Aashrey Child Clinic to know more.