The pneumococcal vaccine is an active immunization agent used to prevent infections caused by Streptococcus pneumoniae, targeting a variety of diseases. This vaccine stimulates the human body to produce antibodies, effectively reducing the risk of infection, especially providing critical protection for infants, the elderly, and immunocompromised individuals. The World Health Organization recommends incorporating the pneumococcal vaccine into routine immunization schedules to reduce hospitalization and mortality related to pneumococcal diseases.
The primary goal of the vaccine is to prevent invasive pneumococcal diseases such as sepsis and meningitis, as well as non-invasive infections like otitis media and community-acquired pneumonia. Vaccination helps establish herd immunity, blocking the transmission of the pathogen within the population.
Pneumococcal vaccines are divided into two main types: conjugate vaccines (PCV) and polysaccharide vaccines (PPV). Conjugate vaccines link the polysaccharides of the pathogen to a protein carrier, stimulating a strong immune response in infants; polysaccharide vaccines are suitable for older children and adults, targeting surface antigens of the pathogen directly.
After vaccination, the immune system recognizes the antigens in the vaccine, producing memory B cells and antibodies. When exposed to the actual pathogen, the immune system can rapidly activate protective mechanisms, preventing bacteria from adhering to tissues and inhibiting their spread in the blood and tissues.
Mainly indicated for: children under 2 years old, adults over 65, patients with chronic cardiovascular, pulmonary, or renal diseases, diabetics, immunodeficiency patients (such as HIV-infected individuals or those on immunosuppressants after organ transplantation), and patients on long-term steroids or chemotherapy.
Indications include prevention of invasive pneumococcal diseases (such as sepsis and meningitis) and non-invasive infections (such as otitis media and sinusitis). Certain occupational risk groups, such as healthcare workers or long-term care facility staff, are also recommended to receive the vaccine to reduce infection risk.
The vaccine is administered via intramuscular or subcutaneous injection, typically in the thigh for infants and in the deltoid muscle for adults. Dosage depends on age and vaccine type; for example, the 13-valent conjugate vaccine (PCV13) is given in 4 doses to infants, while the 23-valent polysaccharide vaccine (PPV23) is usually given as a single dose to adults.
The vaccination schedule must be strictly followed: infants receive doses at 2, 4, and 6 months, with a booster at 12-15 months; if two vaccines are administered, an interval of at least 8 weeks is recommended. Special populations, such as organ transplant recipients, may require adjusted timing and dosage.
The long-term benefits include reducing antibiotic misuse and resistance, and providing indirect protection to unvaccinated high-risk groups (such as immunodeficient individuals) through herd immunity. Economic analyses indicate that each dose of vaccine can save approximately $1,500 to $3,000 in medical costs.
Common local reactions include redness, swelling, or hardness at the injection site. About 80% of recipients may experience mild systemic reactions such as low-grade fever or fatigue, which usually resolve within 2-3 days. Rare allergic reactions, such as difficulty breathing or hives, can occur, and individuals with severe allergies should avoid vaccination.
Uncommon but noteworthy side effects include high fever over 39°C, persistent vomiting, or seizures, which require immediate medical attention. Long-term follow-up studies show no association between the vaccine and autoimmune diseases or neurological disorders.
Contraindications include allergy to any vaccine component, history of severe allergic reactions to previous pneumococcal vaccines, and acute severe febrile illness (vaccination should be delayed until symptoms resolve). Immunodeficient patients may require additional doses to ensure adequate immunity.
Before vaccination, healthcare providers should be informed of health conditions such as:
Pneumococcal vaccines can be administered simultaneously with influenza vaccines at different injection sites but should not be mixed in the same syringe with other injectable vaccines. There are no direct drug interactions with oral antibiotics or chemotherapy drugs, but immunocompromised patients may need timing adjustments.
Administering with immunoglobulins or blood products should be spaced at least 3 months apart to avoid passive antibody interference with vaccine-induced immune responses. When co-administered with tetanus vaccines or Haemophilus influenzae type b (Hib) vaccines, injection sites should be separated.
Clinical trials show that PCV13 provides protection against major serotypes in infants with efficacy rates of 80-95%, while PPV23 offers about 60-70% protection against invasive infections in adults. A 2018 Cochrane review confirmed that vaccination reduces pneumonia hospitalization by 40% and otitis media incidence by 50-60%.
Statistics from Taiwan’s CDC indicate that since the inclusion of routine infant vaccination in 2008, cases of invasive pneumococcal disease in children under 5 have decreased by 75%. Vaccination in long-term care residents has reduced pneumonia-related mortality by 28%, demonstrating significant public health benefits.
Currently, no other vaccines cover all pneumococcal serotypes, but some countries use the 23-valent polysaccharide vaccine as an alternative. Prophylactic use of antibiotics (e.g., azithromycin) is only suitable for short-term high-risk cases and cannot replace long-term protection provided by vaccines.
Immunity after natural infection is unstable and may be accompanied by severe complications. Therefore, the World Health Organization strongly recommends vaccination as the primary prevention strategy rather than relying on natural infection or medication.
The injection site may become red, swollen, or slightly painful, which are normal reactions. Local cold compresses can help reduce swelling, and avoid scratching the injection site; for fever, take antipyretics as advised by your doctor. If fever persists over 48 hours or redness expands, seek medical evaluation immediately.
Do I need to pause caring for infants or immunocompromised individuals after vaccination?The pneumococcal vaccine is an inactivated vaccine and does not contain live pathogens, so there is no need to avoid contact with infants or immunocompromised persons. However, if severe adverse reactions occur (such as high fever or breathing difficulty), reduce contact with high-risk groups temporarily and consult a healthcare provider.
How long does the protection last after vaccination? Is a booster needed?The duration of protection varies by age and vaccine type. For adults receiving PPV23, protection lasts about 5 years; for those over 65, a booster may be recommended after 5 years. The 13-valent conjugate vaccine’s need for a booster depends on age and immune status, and the healthcare provider will assess accordingly.
Can I get vaccinated if I have a cold or mild fever?If symptoms are mild (such as runny nose or slight cough) and body temperature is normal, vaccination can usually proceed. If fever (≥38°C) or acute illness is present, it is advisable to delay until symptoms improve. The decision should be made by a healthcare provider based on individual health conditions.
Does infection after vaccination mean the vaccine failed?The vaccine cannot prevent all strains of bacteria 100%, but it significantly reduces the risk of severe disease. If infection occurs post-vaccination, it may be caused by strains not covered by the vaccine or a weaker immune response. Nonetheless, the vaccine may still reduce the severity of symptoms, and continued preventive measures are recommended as advised by your healthcare provider.
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