15 Pneumococcal disease

Key information

Mode of transmission Contact with respiratory droplets.
Incubation period Asymptomatic nasopharyngeal carriage is common. The incubation period is variable and may be as short as 1–3 days.
Burden of disease Particularly the young, the elderly and the immune compromised.
Funded vaccines 13-valent protein conjugate vaccine, PCV13 (Prevenar 13) for:
  • all children aged under 5 years
  • defined groups of high-risk children and adults.
23-valent polysaccharide vaccine, 23PPV (Pneumovax 23) for: defined groups of high-risk children and adults. 
Funded vaccine indications and schedule Children who have started with PCV10 can continue with PCV13.

All children aged under 5 years: PCV13 at ages 6 weeks, 3, 5 and 15 months.

High-risk children aged under 18 years: age-appropriate high-risk PCV13 schedule, plus 1 dose of 23PPV at age 2 years or older (at least 8 weeks after the last PCV13). If risk persists, revaccinate once with 23PPV, 5 years after the first 23PPV.

High-risk adults: 1 dose of PCV13 followed 8 weeks later with 1 dose of 23PPV. Give a maximum of 3 doses of 23PPV in their lifetime, a minimum of 5 years apart.
Vaccine efficacy/effectiveness For pneumococcal conjugate vaccines: reductions in pneumococcal disease and carriage in vaccinated populations, plus herd immunity effects reducing pneumococcal disease in other age groups; some increases in disease caused by non-vaccine serotypes.
Precautions There may be an increased risk of fever and febrile convulsions with concomitant PCV13 and influenza vaccine in children aged 6–59 months.

​Due to the potential risk of apnoea, PCV13 should be used with caution in very premature babies, but do not avoid or delay immunisation.