Pneumococcal

Quick Facts

• Pneumococcal disease is a bacterial infection caused by  S. pneumoniae (Streptococcus pneumonia). It is the most common cause of bacterial pneumonia and middle ear infection (otitis media) in the U.S., and is the third most frequent cause of bacterial meningitis. [i]
• Pneumococcal bacteria are often found in the upper area of the throat behind the nose in about 5 to 10 percent of healthy adults and 20 to 40 percent of healthy children. However, when pneumococcal bacteria cause invasive infection, serious complications  can lead to inflammation of the brain, blood infections, pneumonia and death.[ii].[iii]
• Pneumococcal bacteria are primarily transmitted through respiratory secretions by coughing and sneezing.  Children and adults living in crowded conditions with poor sanitation and ventilation, such as in daycare centers, military barracks, prisons and homeless shelters, are at higher risk for pneumococcal disease.
• Each year in the U.S., pneumococcal disease is reported to cause about 4,000 cases of blood stream infections (bacteremia), meningitis (brain inflammation) and ear infections in children under five years old.  Some children average one or more middle ear infections (otitis media) each year and many of these ear infections are caused by S. pneumoniae.[iv]
• Globally, 98 percent of pneumonia deaths are caused by pneumococcal infections, primarily in malnourished children living in poverty in underdeveloped countries with inadequate access to healthcare, where S. pneumoniae is the Number One killer of children under age five.. In the U.S. the majority of pneumococcal deaths occur in persons over age 75. In 2008, there were 210 deaths reported in babies under one year old, 118 deaths in children ages one to four years old and 57 deaths in children ages five to 14 years old.[v]
• Symptoms of pneumococcal infection include sudden onset of fever and fatigue, sneezing and cough with mucus and shortness of breath. The infection may start with start with a general feeling of being unwell, a low grade fever and a cough that doesn’t include mucus before symptoms worsen. Symptoms of pneumococcal meningitis (brain inflammation) include stiff neck (inability to touch the chin to chest without moderate to severe pain in the back of the neck and head); headache; extreme fatigue or seizures.[vi] Symptoms of otitis media include a painful ear, red or swollen eardrum, fever, and irritability.[vii]

• There are two types of pneumococcal vaccines licensed and used in the U.S. today: Pneumococcal polysaccharide vaccine (PPSV) and Pneumococcal conjugate vaccine (PCV). PPSV vaccine contains 23 strains of pneumococcal and is recommended by the CDC for adults over 64 years old and PCV13 vaccine contains 13 strains of pneumococcal and is recommended for children between two months and 18 years old.  For more information see links to vaccine manufacturer product inserts.
• The CDC recommends four doses of pneumococcal vaccine (PCV-13) for infants and children, with a dose given at two, four, and six months old and between 12 and 18 months old. One or two doses of pneumococcal vaccine is recommended for children ages two through 18 years, depending on how many doses the child received as an infant. [viii]
• Although pneumococcal vaccine (PPSV-23) is recommended for adults over 64 years old, in 2011 the FDA expanded its approval of PCV-13 vaccine to include adults over age 49 years.[ix]
• By 2008, eight years after pneumococcal vaccine containing seven pneumococcal strains (PCV-7) was licensed in the U.S. and recommended by the CDC for all children, public health officials reported that pneumococcal vaccination programs had been responsible for decreasing the rates of invasive pneumococcal disease in children under age five to about one-fifth of what it was in 1998.[x] However, there was also evidence that mass use of PCV-7 vaccine by American children had put pressure on some of the 80 other pneumococcal strains to cause invasive disease and was responsible for increasing the rates of otitis media caused by serotypes not included in the seven-valent vaccine.[xi] In an attempt to prevent the six additional pneumococcal strains from causing invasive disease, the new pneumococcal vaccine for children (PCV-13) now contains six more pneumococcal strains.
• As of July 2012, there had been more than 34,000 reported adverse events following pneumococcal vaccinations (PCV-7, PCV-13) given to children in the U.S. with 90% of the reported PCV-7 vaccine adverse events occurring in children under age three and 95% of the PCV-13 vaccine adverse events  occurring in children under age six. There have been more than 1,000 deaths and more than 2,000 cases involving convulsions reported following receipt of PCV-7 and PCV-13 vaccines. Reported pneumoccocal vaccine reactions include fever, severe local reactions (swelling, redness, pain at site of injection), irritability, drowsiness, restless sleep, vomiting, diarrhea, rash, decreased appetite, convulsions, asthma, pneumonia and sudden infant death syndrome (SIDS).

• Pneumococcal Vaccine, Polyvalent Merck & Co. Inc. Pneumovax 23 and Licensing Information
• Pneumococcal 7-Valent Conjugate Vaccine (Diphtheria CRM₁₉₇Protein) Pfizer/ Pharmaceuticals Inc. Prevnar and Licensing Information
• Pneumococcal 13-Valent Conjugate Vaccine (Diphtheria CRM₁₉₇Protein) Pfizer/Wyeth Pharmaceuticals Inc. Prevnar 13 and Licensing Information

• CDC on Pneumonia
• CDC on Pneumococcal Vaccination
• CDC Vaccine Information Sheets: Pneumococcal 13-Valent Conjugate Vaccine (Prevnar) andPneumococcal Polysaccharide Vaccine (Pneumovax 23)

Quick Facts Endnotes