When we look at the world in general, morbidity and mortality values due to diseases such as pneumonia, meningitis, encephalitis caused by pneumococcal infections are high in developing countries. Pneumococcal infections have a higher morbidity and mortality in children under one year of age, adults over 65 years of age, and adults with compromised immune systems (such as cancer, asplenia, chronic kidney disease, heart disease). 91 different serotypes of S. pneumoniae, which is the causative agent of the disease, have been identified, and 20 of them, which are common, are responsible for 70% of pneumococcal infections. Vaccine development studies have focused on the effects of more of these serotypes.
Pneumococcal vaccine has been introduced in 129 countries as of 2015, and the vaccination rate is estimated to be around 37.0% globally.
Table of contents
- 1 Who is at risk for pneumococcus?
- 2 What are the types of pneumococcal vaccine?
- 3 How is the pneumococcal vaccine administered?
- 4 What are the possible side effects after pneumococcal vaccine?
- 5 Is pneumococcal used in adults?
- 6 Who should not be given the pneumococcal vaccine?
- 7 How is pneumococcal vaccine stored?
Who is at risk for pneumococcus?
- Babies under one year old
- Adults over the age of 65 are at risk for pneumococcus.
However, the following people in the 2-64 age group are also at risk:
- Those who have their spleen removed or patients at risk of removal (such as Celiac disease),
- Those with chronic lung disease,
- heart patients,
- Chronic liver patients (such as cirrhosis),
- Cancer patients,
- Diabetes patients,
- Those with a disease that suppresses the immune system, such as HIV,
- Metal workers,
- Health personnel.
What are the types of pneumococcal vaccine?
There are two types of pneumococcal vaccines: polysaccharide pneumococcal vaccine (PPA) and conjugated pneumococcal vaccine (KPA).
Polysaccharide pneumococcal vaccines (PPA): It has been used since the 1980s and its effectiveness is around 85-90%. However, as with other polysaccharide vaccines, there is no T cell stimulation under 2 years of age, so the immune response is weak and the efficacy is low. PPA was first produced in 1945 as a 4-valence, then in the 1970s as a 14-valent and finally in 1983 as a 23-valent. Conjugated pneumococcal vaccines (KPA): Conjugated polysaccharide vaccines containing 7, 10 or 13 pneumococcal serotypes (KPA 7, KPA 10 and KPA 13), respectively, have been licensed and marketed all over the world, and KPA 10 and KPA 13 are still widely used. Work continues for KPA 20. With this vaccination, not only the children who are vaccinated, but also the elderly population, thanks to the decrease in carriage, provide protection against pneumococcus. The protection of the vaccine is between 70.0-97.0%.
Conjugated pneumococcal vaccines provide longer-lasting immunity thanks to a T-cell-mediated immune response. On the other hand, it indirectly protects unvaccinated people as it prevents pneumococcal colonization in the nasopharynx.
How is the pneumococcal vaccine administered?
Polysaccharide pneumococcal vaccines are administered intramuscularly (preferably the deltoid muscle) or subcutaneously. It is not administered in the same syringe and application site as other vaccines. A single dose of PPA23 is recommended for children over two years of age and adults (especially 65 years and older), and a second dose if the risk is very high.
Conjugated pneumococcal vaccines can be used sequentially in high-risk children over 2 years of age and adults, provided that it is 8 weeks before PPA. Three or four doses are recommended for 5 years and younger, and a single dose is recommended for risk groups over 6 years old and people over 65 years old. It is usually administered in three doses, two doses at the end of the second and fourth months and a booster dose at the 12th month.
What are the possible side effects after pneumococcal vaccine?
Redness, pain, fever, weakness, drowsiness may be seen at the injection site. Rarely, it carries the risk of anaphylaxis. Side effects may occur depending on the toxin (diphtheria, tetanus, etc.) contained in conjugated vaccines.
Is pneumococcal used in adults?
It can be used in adolescents and adults who have not been previously vaccinated, live in or will travel to endemic areas. Polysaccharide vaccines are administered after 2 years of age.
Who should not be given the pneumococcal vaccine?
It should not be administered to those who have developed a severe allergic reaction at previous doses, and those who have developed a severe allergic reaction due to diphtheria / tetanus toxin in conjugate vaccines. It is not applied until the picture heals in diseases progressing with high fever. It can be used in pregnant women, except in the first trimester, in case of high risk of disease.
How is pneumococcal vaccine stored?
Store at 2-8°C, protect from light, do not freeze.