Pneumococcal Disease (PCV13)

Streptococcus pneumoniae (also called pneumococcus) is the most common cause of pneumonia. Because more antibiotics are now resistant to many of the pneumococcus strains, preventing pneumococcal disease is much better than trying to treat it.

Key Facts

  • Pneumococcal infections are among the most common invasive bacterial infections in children in the United States and a common cause of ear infections.
  • Being younger than 5 and older than 65 puts you at higher risk of getting a serious case of the disease.
  • Since the decline of HIB disease in the US, Streptococcus pneumoniae has become the leading cause of bacterial meningitis in children under 5 years old.

What is pneumococcal disease?

Pneumococcal disease is caused by the bacteria Streptococcus pneumoniae (S. pneumoniae) and can lead to serious infections such as pneumonia, meningitis (brain inflammation), septicemia (an infection in the blood) and is also a common cause of ear infections (otitis media). Because pneumococci are common inhabitants of the respiratory tract the disease is easily spread by coughing and sneezing. The symptoms of an infection depend on where the infection is located. With pneumococcal pneumonia a person will have fever, cough, rapid and or difficulty breathing, and sometimes chest pain. With meningitis they may have a stiff neck, fever, confusion, and sensitivity to light, and of course with an ear infection they will have ear pain. It is possible to be an asymptotic carrier. That means you can be spreading the disease without having any symptoms.

Pneumococcal disease doesn’t play fairly. Like Hib diseases, it frequently infects the most vulnerable members of the community: the very young and very old.

Did You Know?

Pneumococcal disease kills more people in the US each than all other vaccine-preventable diseases combined.

The Vaccine

Unfortunately, there are more than 90 types of pneumococcal bacteria. The current vaccine, PCV13, protects against 13 of those strains. These 13 strains cause the most severe infections in children. The earlier PCV7 vaccine (which protected against 7 strains) was so effective that by 2007 the incidence of pneumococcal disease decreased by 99%. In 2010 the vaccine was updated to protect against 6 additional strains for a total of 13 strains. –Immunize for Good

The pneumococcal conjugate vaccine is given to young infants because that is when they are at the greatest risk for severe diseases caused by a pneumococcal infection.

A vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions. No moderate or severe reactions have been associated with this vaccine. The risk of this vaccine causing serious harm is extremely small.

Adverse reactions to the vaccine may include:

  • Drowsiness or loss of appetite (50%)
  • Swelling at injection site (1 in 3)
  • Mild fever (1 in 3) or high fever in less than 1%
  • Fussiness or irritability in infants (8 in 10)

 

Different Pokes for Different Folks

There are 2 types of vaccine:

PCV or PCV13: Pneumococcal conjugate vaccine for all infants and children, and adults 19 years and older at high risk for disease.

PPSV or PPSV23: Pneumococcal polysaccharide vaccine for all adults 65 years and older and those 2 years of age and older at high risk for disease.

More Numbers, Please!

Before pneumococcal conjugate vaccine became available for children, pneumococcus caused 63,000 cases of pneumococcal disease and 6,100 deaths in the US each year. Many children who developed pneumococcal meningitis also developed long-term complications such as deafness or seizures. Since the vaccine was introduced, the incidence rate of invasive pneumococcal disease in children has been reduced by about 85%.

Pneumococcal conjugate vaccine also reduces spread of pneumococcus from children to adults. In 2011 alone there were 35,000 fewer cases of invasive pneumococcal disease caused by strains included in the vaccine, including 21,000 fewer cases in children and adults too old to receive the vaccine. If we were to stop immunizing, we would likely soon return to the pre-vaccine numbers of invasive pneumococcal disease cases and deaths.

Invasive Pneumococcal Disease Incidence by Age Group, 1998 and 2008

graph showing rate of Invasive pneumococcal disease by age group (1998-2008) as discussed in the Secular trends in the united states section

*Rate per 100,000 population. PCV7 licensed in 2000.
Source: Active Bacterial Core Surveillance/EIP Network

Common Misconceptions

Pneumonia is really just a bad cold.

Well, maybe like a super, super bad cold that might cause you to be hospitalized. Actually colds are caused by viruses. While pneumonia can also be caused by a virus, we aren’t talking about that kind here. Bacterial pneumonia is treated with antibiotics and more and more of those drugs just aren’t working. A cold may last only a few days, maybe a week or two with symptoms that include a runny nose, sore throat, sneezing and coughing. Pneumonia (all kinds, not just those caused by s. pneumoniae) is much more serious, killing more than 50,000 Americans and more than 1 million children worldwide each year.

Pneumonia doesn’t affect healthy people.

While serious illness and deaths from pneumonia are more common in individuals with weakened or compromised immune systems, pneumonia can affect anyone. And like many diseases, it is especially dangerous for the very young and very old. Having good health habits such as proper nutrition, breast feeding, getting exercise and getting our vaccines are all ways we can lower our risk of getting pneumonia.

Pneumonia can be treated but it can’t really be prevented.

This statement had more truth to it before the time of increasing resistance to antibiotics and before there was a good vaccine. Preventing pneumonia can be done in a variety of ways, with the best defense being a combination of preventative measures.

1) vaccination

2) early treatment with antibiotics of confirmed cases

3) exclusively breastfeeding infants for their first 6 months of life

4) good nutrition and hygiene habits

5) limiting exposure to smoke from cigarettes or indoor cookstoves and fires

Bringing It Home

Vaccines are a gift. No one understands that better than an Ashland mom whose precious boy died from pneumococcal meningitis. The current PCV13 vaccine was not available during his short life. Read Dylan’s story.

Guess Who

Which of these famous people died of pneumonia?

  1. Astaire, Fred
  2. Buchanan, James
  3. Gardner, Ava
  4. Hope, Bob
  5. Houston, Sam
  6. Keiko
  7. Kunitz, Stanley
  8. Marx, Groucho
  9. Muir, John

 

YEP! You guessed it; they all did. Pneumonia is a serious disease that does not respect race, social class or age.

Sources

CDC, Pink Book

Immunize for Good: Pneumococcal Disease

University of Maryland Medical Center