Pneumococcal Disease
The pneumococcal bacteria are the most common cause of Pneumonia, Meningitis, Sepsis, Sinusitis, and ear infection in children under 2 years. The pneumococcal polysaccharide vaccine (Pneumovax) has been available for many years but had not been recommended for children under 2 years old because it was not effective in this age group.
A new pneumococcal conjugate vaccine (Prevnar) has recently became available. This vaccine targets the 7 most common disease-causing types of pneumococcus. Pneumococcal Disease is the leading cause of Bacterial Meningitis (swelling of the brain and spinal cord) in children 5 and younger. It can also cause severe blood infections (bacterium) and lung infections (Pneumonia).

This is spread to people by droplets of bacteria that are inhaled. For bacteremia and Meningitis fatality, per case is 10-20% in infants and up to 80% in elderly people. Pneumococcal infections can be treated with antibiotics but vaccination is becoming an important method of prevention since bacteria resistance to antibiotics is becoming a problem.

There are two types of pneumococcal vaccines:
1) The Pneumococcal polysaccharide vaccine is recommended for children over 2 years with high risk of disease (lack of spleen, Sickle Cell Disease, Nephrotic Syndrome, CSF leak, and immunosuppression including HIV infection). This vaccine is also recommended for adults 65 years and older, those with chronic diseases, immunocompromization, HIV infection, and those in high-risk occupations. One vaccination is enough but people at very high risk may have a single booster after 5 years. This vaccine is not effective in children under 2 years.
2) The pneumococcal conjugate vaccine is a different vaccine recommended for children <24 months and is given at 2,4,6 and 12-15 months. Unvaccinated children >7 need fewer boosters. It is recommended to consider vaccinating all children aged 24-59 months as well.
Adverse effects include local reactions (polysaccharide 30-50%, Conjugate 10-20%) and fever or muscle aches (polysaccharide <1%, conjugate 5-24%) but there are no severe reactions.