The vaccines PCV13 and PPSV23 protect against infections with the bacteria that causes pneumococcal disease. The disease is usually mild, but children are more likely to suffer permanent disabilities or death.
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Table of Contents for Pneumococcal Disease
How do you get pneumococcal disease?
How many people get pneumococcal disease every year?
What are the symptoms of pneumococcal disease?
How soon do symptoms appear?
What are complications of pneumococcal disease?
How is pneumococcal disease treated?
How effective is the pneumococcal vaccine?
What is the immunization schedule for pneumococcal-disease?
What are pneumococcal vaccine names?
Pneumococcal disease is an infection caused by Streptococcus pneumoniae, a bacteria also known as “pneumococcus.” The infection is usually mild, but it can cause very severe symptoms or death, especially in children under 5 years old.
Pneumococcal infections are also sometimes called Streptococcus pneumoniae infections.
Pneumococcal disease spreads when a person who is infected coughs or sneezes. Some children who have pneumococcus bacteria in their nose and throat do not feel sick, but they are still contagious. The disease spreads as long as the bacteria is in the nose and throat.
Hundreds of thousands of Americans get pneumococcal disease every year. Most illnesses are mild, but around 31,600 serious illnesses and 3,300 deaths from pneumococcal disease (bacteremia and meningitis) occurred in the United States in 2012.
The disease is usually more serious in children and adults over 65 years old. On average, around 2,000 children under 5 years old develop a life-threatening illnesses, and approximately 1 out of 15 children die from pneumococcal disease.
There are over 90 types of pneumococcal bacteria and many types of pneumococcal infections. The symptoms depend on the part of the body that is infected, such as the lungs, brain, spinal cord, blood, or ears.
Up to 50% of all middle ear infections (otis media) are caused by pneumococcal disease. The symptoms include ear pain, red and swollen ear drum, and sometimes fever or sleepiness.
The most common disease is pneumococcal pneumonia (lung infection). As many as 900,000 Americans get pneumococcal pneumonia every year in the U.S. The fatality-rate is 5-7%, but up to 50% in elderly people. The symptoms may include:
- Sudden fever
- Shaking chills
- Rapid breathing or difficult breathing
- Chest pain
Pneumococcal disease causes 50% of all cases of bacterial meningitis in the United States, or around 3,000 cases per year. Meningitis is an infection of the covering of the brain and spinal cord. The fatality-rate is around 10% and permanent brain damage is common. The symptoms may include:
- Stiff neck
- Sensitivity to light
- Low alertness and vomiting in babies
Bloodstream infections with pneumococcal bacteria can cause bacteremia (blood infection) and sepsis. There are around 12,000 cases of pneumococcal bacteremia every year in the U.S., with a fatality-rate of 15%. Up to 60% of cases are dealy in elderly people. The symptoms may include fever, chills, and low alertness.
The incubation period depends on the type of infection, but it can be as short as 1-3 days for pneumococcal pneumonia (lung disease).
- Bacteremia (blood poisoning)
- Brain damage
- Loss of arms or legs
Treatment for pneumococcal disease involves penicillin, but antibiotic-resistance is on the rise. In 2011, nearly one-third of pneumococcal bacteria were resistant to at least one antibiotic. Treatment is far more difficult and complications more likely when antibiotics do not work.
There are two types of pneumococcal vaccines:
- PCV13 Conjugate Vaccine: Protects against 13 types of pneumococcus that cause severe illnesses in children and elderly adults. PCV13 (Prevnar13®) was approved in 2010 to replace PCV7 (Prevnar®) for children as young as 6 weeks, adults age 65 and older, and others with certain risk-factors.
- PPSV Polysaccharide Vaccine: Pneumovax23® Protects against 23 types of pneumococcal. It is approved for routine use in adults 65 and older and younger people with certain risk-factors
Overall, PPSV is 50-80% effective at preventing invasive pneumococcal disease. It may not work as well in adults over 65 years old and people with certain underlying illnesses, but vaccination is still recommended because they have a high risk of a severe disease.
Doctors recommend that children get four doses of the PCV13 pneumococcal vaccine for the best protection. One shot is given at each of the following ages:
- 2 months
- 4 months
- 6 months
- Between 12 and 15 months of age
All adults should get a dose of PCV13 at the age of 65 years old, and a dose of PPSV at the age of 66 years old. Adults usually need only one dose of PCV13 and one dose of PPSV, but booster shots may be necessary for adults with a high risk of pneumococcal disease.
- Pnuemovax 23® (PPSV23 vaccine)
- Prevnar 13® (PCV13 vaccine)
Yes. The risk depends on the vaccine, but severe side effects like allergic reactions are very rare. Both PPSV and PCV13 are inactivated vaccines that contain only part of the bacteria. The vaccines can’t cause pneumococcal disease.
The most common side effects of the pneumococcal vaccine PCV13 are mild. They include fussiness or irritability (80%), drowsiness (50%), temporary loss of appetite (50%), swelling where the shot was given (30%), mild fever (30%), and fever over 102ºF (5%).
The most common side effects of PPSV are redness or pain where the shot was given (30-50%). Fewer than 1% of people develop a fever, muscle aches, or more severe reactions at the injection site. Serious allergic reactions have been reported in very rare cases.
There have been reports of patients developing Guillain-Barre Syndrome (GBS), a disease that can cause severe muscle weakness or paralysis. It is unknown if GBS is caused by the vaccine.
The estimated risk of a severe allergic reaction is less than one in a million doses. The symptoms may include hives, wheezing, swelling of the mouth and throat, low blood pressure, breathing problems, and shock within a few hours of receiving the vaccine.
Shoulder Injury Related to Vaccine Administration (SIRVA) is a side effect when the needle accidentally hits the bursa, ligaments, or tendons in the shoulder. It can cause chronic pain and weakness.