Questions and answers on the Pneumococcal conjugate vaccine- Pneumococcal - Diseases and Vaccines

Immunisation
Questions and answers on the Pneumococcal conjugate vaccine

From June 2008, the Pneumococcal conjugate vaccine will be offered to babies. Four doses of vaccine are given at 6 weeks, 3 months, 5 months and 15 months of age. Questions and answers on the Pneumococcal conjugate vaccine are provided below:

What does the pneumococcal conjugate vaccine protect against?
The pneumococcal conjugate vaccine protects against pneumococcal disease caused by the 7 most common strains of the Streptococcus pneumoniae bacteria (pneumococcal bacteria).

The disease is spread from person to person, usually by sneezing or coughing.

Infection with the pneumococcal bacteria can cause pneumonia and bacteraemia (blood poisoning) in all age groups, and meningitis (an infection of the brain membranes) in very young children. Pneumococcal infections can also cause otitis media (middle ear infection sometimes leading to deafness) and sinusitis (inflammation of the sinuses). The effects of pneumococcal disease are most severe in children under two years, and in the elderly.

Why is the pneumococcal conjugate vaccine being funded from June 2008?
The pneumococcal vaccine is being funded from June 2008 to protect young children against pneumococcal disease caused by infection with Streptococcus pneumoniae.
New Zealand has relatively high rates of pneumococcal disease, particularly among Maori and Pacific children. In 2006, 151 children under the age of five contracted pneumococcal invasive disease – that is severe disease such as pneumococcal meningitis and septicaemia (blood poisoning).

Who is eligible to get the funded pneumococcal conjugate vaccine in 2008?
The vaccine will be free for all babies born from 1 January 2008.

However, the vaccine programme will start from 1 June 2008.

Those babies born between 1 January and 1 June 2008 will be recalled by their doctor to receive the pneumococcal vaccine from 1 June 2008.

How many injections of pneumococcal conjugate vaccine does my baby need and when are they given?
Your baby’s age (when they receive the first dose) determines how many doses are required, and when they are given.

For babies who are 6 weeks of age at the first dose:

the pneumococcal vaccine is given at the same time as other immunisations on the National Immunisation Schedule – at 6 weeks, 3 months, 5 months and 15 months of age.

For babies born from 1 January to May 2008:

who will be up to 6 months of age at the first dose - 3 doses are given 6 to 8 weeks apart, and a 4th dose is given at 15 months of age.
who will be 7 months to 11 months of age at the first dose - 2 doses are given 6 to 8 weeks apart, and a 3rd dose is given at 15 months of age.

Can other immunisations be given at the same time as the pneumococcal conjugate vaccine?
Avoid giving PCV7 (Prevenar®) at the same visit as MeNZB™ vaccine
While no problems are anticipated, either in the immune response or safety, there is no data to support giving the MeNZB™ vaccine at the same practice visit as Prevenar®. Therefore, where parents are anxious for their child to receive the MeNZB™ vaccine and the doctor agrees, a three-dose course of the MeNZB™ vaccine could start at six months of age (doses six weeks apart).

Is the pneumococcal conjugate vaccine safe?
Yes. The pneumococcal vaccine was licensed in New Zealand in 2002, and is used by many countries worldwide (including Australia, the United States and Canada) as part of their infant immunisation schedules. The vaccine has been given to over 20 million children in the United States, and no significant serious side effects have been identified.

The most common side effects seen after pneumococcal immunisation are redness or swelling at the injection site. Temporary fever may occur in some babies. These are common vaccine side effects, and are known to occur after immunisations with other infant vaccines.

How effective is the pneumococcal conjugate vaccine?
In the United States, the incidence of invasive pneumococcal disease in children (for the 7 strains targeted by the vaccine) has fallen by 94 percent since the vaccine was introduced in 2000.

In the United States, pneumococcal disease rates have also decreased in populations who haven’t received the pneumococcal vaccine. Disease reduction in unvaccinated people is known as ‘herd immunity’. Herd immunity is probably the result of decreased disease transmission from younger, vaccinated children. Herd immunity can lead to a significant reduction in hospital admissions and adult deaths from the disease.

How effective will the pneumococcal conjugate vaccine be in New Zealand?
In 2004, Environmental Science and Research (ESR) indicated that 161 children under 5 years had invasive pneumococcal disease. By comparing the pneumococcal disease strains that caused the disease against the seven strains in the pneumococcal vaccine, ESR predicted that 79 percent of pneumococcal disease in those under 5 years may have been prevented by the use of the pneumococcal vaccine.

Can I choose to pay for the pneumococcal conjugate vaccine?
Yes. If your child will not be eligible to receive the funded vaccine from 1 June 2008, you can choose to pay for it. The vaccine is available to purchase from your doctor. Children aged 6 weeks to 9 years can receive the vaccine. Please speak to your doctor or practice nurse.

Is the pneumococcal conjugate vaccine already funded for some groups of babies or children?
Yes. The vaccine is funded for a small group of babies and children under five years of age who are most at risk of complications from pneumococcal disease.

Pneumococcal immunisation is recommended and free for high risk babies and children under five years of age in the following groups:

children with chronic CSF leaks
children with cochlear implants or intracranial shunts
children with HIV infection
children with primary immune deficiencies
children with acute leukaemia, acute lymphoma and following bone marrow transplant
children on immunosuppressive therapy or radiation therapy
children following organ transplantation
children with renal failure or nephrotic syndrome
children receiving corticosteroid therapy for more than two weeks, who are on an equivalent daily dosage of prednisone of 2 mg/kg per day or greater, or children who weigh more than 10 kg on a total daily dosage of 20 mg or greater

Babies, children and adults who have had their spleen removed or who are due to have their spleen removed are also eligible for other free immunisations to protect them against disease. Please speak to your doctor or practice nurse.

References
Center, KJ. 2007. Prevenar vaccination: Review of global data, 2006.Vaccine 25: 3085-89.

Pneumococcal conjugate vaccine for childhood immunization – WHO position paper. 2007. Weekly Epidemiological Record 82:93-104.

Ministry of Health. 2006. Immunisation Handbook 2006. Wellington: Ministry of Health.

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Page last updated: 19 May 2008