Pneumococcal Infection

Disease risk areas
Worldwide.

Transmission
Spread by droplet infection

Recommendations
Recommended in UK for all those over 2 years old who are likely to be at risk e.g: those with homozygous sickle cell disease, asplenia or a nonfunctioning spleen, chronic renal disease or nephrotic syndrome, immunocompromised, chronic heart, lung, or liver disease, diabetes mellitus.

Vaccination

Always confirm details with manufacturer's literature
Type: Killed
No of doses: 1
Dosage: 0.5 ml
Route: deep SC or IM
Length of protection: 60% protection, wanes after 5 yrs
Boosters: Not usually given but may be given 5-10 yearly to at high risk of serious disease such as those with no spleen or nephrotic syndrome.
See also below under side effects.
To achieve maximum response vaccination should whenever possible be performed 2 weeks beforesplenectomy.
Prophylactic penicillin may also be advised for children with sickle cell disease or other spleen disorders.

Side effects
Swelling and redness at the injection site can occur and occasionally low grade fever. Intradermal injection is not recommended as it can cause a severe local reaction.
Re-immunisation is more likely to cause severe reactions especially if given sooner than 5-10 years after a previous dose. As described above it may be possible to check antibody levels to see if re-vaccination is necessary.

Contra-indications
Vaccine should not be given during an acute infection. It has not been evaluated during pregnancy. Reimmunisation within 3 years is contra-indicated.

Supplies
Vaccine is supplied by Merck, Sharpe and Dohme Ltd, Hertford Road, Hoddesdon Herts EN11 9BU Tel.0992 467272.