Pneumococcal vaccine

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Questions:-

1) What is pneumoccoal disease?

2) Who should be vaccinated with pneumococcal vaccine?

3) Pneumococcal vaccine timing explained

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Pneumococcal Disease (PnD) manifestations includes:-

- meningitis (infection of the lepto-meninges, covering of the brain)

- middle ear infection

- pneumonia (lung infection)

- sepsis (bacteria in the blood-stream)

Mode of transmission: air droplets via cough or sneezing

Children below 24 months old is at the highest risk of these infection

Around 60% of the preschool children is carrying this bacteria and transmission of this bacteria become imminent when they goes to day care centre.

Therefore, these group target group for pneumoccal vaccination:-

1 extreme ages (<> 65 years-old)

2 individuals with chronic disease (diabetes mellitus, heart disease, chronic obstructive lung disease, alcoholism)

3 individuals with spleen removed (2weeks before splenectomy)

4 individuals had organ transplantation and on immunosuppression

Vaccination timing:~

reference:

a) http://www.azdhs.gov/phs/oids/abx/images/prevnar.pdf

b) http://www.merck.com/product/usa/pi_circulars/p/pneumovax_23/pneumovax_pi.pdf

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Notes:

1) 1 dose = 0.5ml intramuscular/ subcutaneous injection

2) PREVNAR = heptavalent pneumococcal conjugate vaccine (PCV7)

3) PNEUMOVAX 23 = 23-valent pneumococcal polysaccharide (23PS)

4) for adults, only 1 dose is required. However may need to be repeated 5 to 10 years time.

5) following vaccination, serotype-specific antibody levels decline after 5-10 years.

6) Efficacy in immunocompetence individual is around 50 to 80%

7) PNEUMOVAX 23 may not be effective in preventing pneumococcal meningitis in patients who have chronic cerebrospinal fluid (CSF) leakage resulting from congenital lesions, skull fractures, or neurosurgical procedures.