Immunization : Pneumococcal Vaccine (Polysaccharide - for age 2 years and over)

Vaccines or needles are the best way to protect against some very serious infections. The National Advisory Committee on Immunization strongly recommends routine immunization.

This vaccine protects adults and children two years of age and older against pneumococcal infections like pneumonia. This type of vaccine (polysaccharide) is only effective in people two years of age and older, and should not be given to children under two years of age. A different type of pneumococcal vaccine (conjugate) is effective in children under two years of age. This fact sheet refers to the "polysaccharide" vaccine only.

There are two main kinds of pneumonia, one caused by viruses and the other caused by bacteria. One type of bacteria is called Streptococcus pneumoniae (or pneumococcus). When these bacteria invade the lungs, they cause bacterial pneumonia. Most cases of bacterial pneumonia are caused by pneumococcus. These bacteria also attack different parts of the body. They can attack the blood cells and cause a serious infection called bacteraemia. They can also cause meningitis. Meningitis is a serious infection of the fluid and lining of the central nervous system. Pneumonia, bacteraemia or meningitis can cause death, particularly in people with high-risk medical conditions and the elderly. Healthy people often have pneumococcal bacteria in their mouths and upper respiratory systems. In most people, the bacteria will not cause serious illness. But in some people with high-risk medical conditions, the bacteria can cause disease when they get into the lungs or blood.

Pneumococcal pneumonia, bacteraemia and meningitis are serious. Also, the pneumococcus bacteria are becoming increasingly resistant to antibiotics such as penicillin and others.

Pneumococcal vaccine can prevent pneumonia and other infections caused by 23 types of the Streptococcus pneumoniae bacteria. These 23 types account for approximately nine out of 10 cases of pneumococcal disease. The vaccine is recommended for people with certain medical conditions listed below, and people 65 years of age and older. About eight out of 10 cases occur in these high- risk groups. The vaccine protects about 50 to 80 per cent of people against pneumococcal infection. Vaccination also makes the disease milder for those who may catch it. This pneumococcal vaccine has been used in Canada since 1983.

Pneumococcal vaccine should be given to anyone 65 years of age and older, as well as adults and children two years and older who have the following high-risk medical conditions :

• chronic heart, kidney or lung disease (except asthma);
• nephrotic syndrome;
• cirrhosis of the liver;
• alcoholism;
• diabetes mellitus;
• chronic cerebrospinal fluid leak;
• HIV infection and AIDS;
• other diseases that suppress the immune system;
• no spleen or a spleen that does not work properly;
• sickle cell disease.

The best time to get the needle is as soon as you develop a high-risk medical condition or when you turn 65. Because many people who should get the pneumococcal vaccine also get the flu shot (influenza vaccine) every autumn, it would be a good idea to get them both at the same time. But remember - the pneumococcal vaccine is usually given just once in your lifetime and the influenza vaccine is given every year. Only a few people will need a second dose of the pneumococcal vaccine. Your doctor will know if you need another dose.

Some people have side effects from the vaccine, but these are usually minor and last only a short time. It is quite common to have some swelling and soreness in the arm where the needle was given. Occasionally slight fever may occur. Other side effects - such as headache, a higher fever or fatigue may occur, but these are rare. You should always discuss the benefits and risks of any vaccine with your doctor.

The pneumococcal vaccine used between 1978 and 1983 protected against only 14 types of the pneumococcus. People who received this vaccine do not usually need to get another shot.

• If you think you have already been vaccinated for pneumococcal disease, let your doctor know.
• The polysaccharide pneumococcal vaccine is not recommended for children under two years of age.
• You should not have the vaccine if you have a severe allergy to any component of the vaccine.

Talk to your doctor or call your local public health unit.

After you get any immunization, make sure your doctor updates your personal immunization record, such as your "Yellow Card". Keep it in a safe place !

March 2002