Pneumococcal vaccination is recommended for individuals at increased risk of pneumococcal infection as follows:
age over 65 years
asplenia or splenic dysfunction (including homozygous sickle cell disease and coeliac disease which could lead to splenic dysfunction);
chronic respiratory disease (includes asthma treated with continuous or frequent use of a systemic corticosteroid);
chronic heart disease;
chronic renal disease;
chronic liver disease;
diabetes mellitus requiring insulin or oral hypoglycaemic drugs;
immune deficiency because of disease (e.g. HIV infection) or treatment (including prolonged systemic corticosteroid treatment);
presence of cochlear implant;
conditions where leakage of cerebrospinal fluid may occur;
Child under 5 years with a history of invasive pneumococcal disease.
Choice of vaccine- The 7-valent pneumococcal polysaccharide conjugate vaccine (PCV-7) is now a component of the primary course of childhood immunisation. The recommended schedule consists of 3 doses, the first at 2 months of age, the second at 4 months, and the third at 13 months. Children at increased risk should also receive a single dose of the 23-valent pneumococcal polysaccharide vaccine (PPV-23) after their second birthday.
Children at increased risk of pneumococcal infection presenting late for vaccination should receive 2 doses (separated by at least 1 month) of pneumococcal polysaccharide conjugate vaccine (PCV-7) before the age of 12 months and a third dose at 13 months.
