Prevention of serious pneumococcal infections

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What is it about ?

Pneumococcal infection is caused by a bacterium, Streptococcus pneumoniae, which is the leading cause (30 to 40%) of pneumonia (infection of the lungs). The pneumococcus is also responsible forotitis media, of sinusitis (infection of the sinuses, which are cavities in the bones of the skull) and meningitis. This germ also causes widespread infections throughout the body which often results in death. Pneumococcal infections are more common in infants, young children and people over 60 years old. The group of people at greatest risk of generalized infection includes the elderly, people with compromised immune systems, and those who have had their spleen removed.

What is its frequency?

In Belgium, the general practitioner makes the diagnosis of pneumonia in nearly 5 out of 1,000 patients per year. Among people over 60 years of age, pneumonia affects 25 out of 1,000 patients annually, and in 30 to 40% of cases, the causative organism is pneumococcus. The mortality from pneumococcal pneumonia is 5-10%. Mortality from pneumococcal infection in the elderly and in those with chronic disease is 30-50%. The number of serious infections in people over 65 is estimated in our country at 1,000 to 1,200 per year.

How to prevent severe pneumococcal infection?

Two different vaccines are available, one for adults and children over two years old, and one for infants and young children. This patient guide deals only with the vaccine for adults.
Despite the lack of evidence for vaccine prevention of pneumococcal pneumonia, studies show, however, that the vaccine prevents half of serious infections in the elderly and in certain risk groups. It is for this reason that these people should be vaccinated. The groups at risk are:

  • people over 50 who have chronic (long-term) cardiovascular disease, chronic lung disease (apart from asthma), who present with alcohol abuse,
  • people over 65,
  • people without a spleen.

In some groups, a vaccination booster is necessary:

  • a single booster vaccine, i.e. five years after the first vaccine, in people over 65 years of age and in people without spleen;
  • booster vaccine every 5-7 years if the first pneumococcal vaccine was given because of a chronic condition.

For other groups at risk, it is not necessary to systematically do a booster vaccine.
Side effects of the vaccine are usually limited to a sensitive area at the injection site (3% after the first vaccination and 11% after a booster vaccination). Serious side effects are rare.
Although the vaccine has not been shown to be safe in pregnant women, there is little reason to believe that vaccination during the first trimester of pregnancy would have an impact on the development of the fetus.
The vaccine cannot be administered if it is known that there has been a severe sensitivity reaction to a previous administration or to any component of the vaccine.

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