Health Tips

Since 1 December 2020, pneumococcal vaccination is offered to every child who was born on 1 January 2020 and later at all Ministry of Health’s health clinics (Klinik Kesihatan KKM).

Indeed! Pneumococcal vaccine is the latest addition to the mandatory National Immunisation Programme (NIP) that aims to protect Malaysian children against 13 major childhood diseases. The pneumococcal vaccine protects the children against pneumococcal disease, which is an infection caused by bacteria called Streptococcus pneumoniae (S.pneumoniae), or pneumococcus.

What’s a pneumococcal disease?

Streptococcus pneumoniae (pneumococcus) is a leading cause of serious illness in children, especially in the developing world. It is estimated that about one million children die of pneumococcal disease every year. 

Image credit: https://www.nfid.org/infectious-diseases/pneumococcal/

Pneumococcal disease can affect various body systems and organs:

• Middle ear infection (otitis media) — Ear infections are usually mild and are more common than the more severe forms of pneumococcal disease. However, some children develop repeated ear infections and may need ear tubes.

• Sinus infection, which can involve stuffy or runny nose, headache, postnasal drip (mucus building up in the back of the throat or nose) and facial pain or pressure. 

These are considered milder cases of pneumococcal disease. Sometimes, pneumococcal disease can be deadly or result in long-term disability in children:

• Pneumonia — Pneumonia happens when the pneumococcus infects the lung. This may cause the children to experience difficulty in breathing, fever, cough and chest pain.

• Meningitis — Pneumococcus can infect the lining of the brain and spinal cord, thus causing meningitis. 1 in 12 children who get pneumococcal meningitis dies of the infection. Those who survive may have long-term problems, such as hearing loss or developmental delay.

• Blood infection and sepsis — This is when the bacteria enters into the bloodstream, causing fever, chills, alertness; the organs may start shutting down due to the overwhelming infection. It kills 1 out of 30 children who get it, and those who survive may suffer from lifelong disabilities.

Good news is, vaccines can help prevent pneumococcal disease. Vaccination is the best way to prevent pneumococcal disease.

Get to know pneumococcal vaccines

Before we talk about the pneumococcal vaccine, let’s understand that there are many serotypes of pneumococcal out there. Serotypes are groups within a single species of microorganisms, such as bacteria or viruses, which share distinctive surface structures. More than 90 types of capsular polysaccharide (serotype) have been identified in the pneumococcal group. Each type of capsular polysaccharide may trigger a specific immune response that is different from other serotypes. Just imagine them as a single group of bacteria wearing different colors of hats. An ideal pneumococcal vaccine should cover as many serotypes of pneumococcal as possible to provide maximum protection.

Mainstream pneumococcal vaccines are:

• 10-valent Pneumococcal Conjugate Vaccine (PCV10) Brand: SII PNEUMOSIL®

• 13-valent Pneumococcal Conjugate Vaccine (PCV13) Brand: Prevnar 13®

• 23-valent Pneumococcal Polysaccharide Vaccine (PPSV23) Brand:Pneumovax23®

In the United States, PCV13 is recommended for all children younger than 2 years old and people 2 years or older with certain medical conditions. PPSV23 is recommended for  all adults 65 years or older, people 2 through 64 years old with certain medical conditions, and adults 19 through 64 years old who smoke cigarettes.

Nonetheless, in Malaysia, the cheaper option of PCV10 is offered to Malaysian children instead. According to a report published by the Health Technology Assessment Section (MaHTAS), PCV10 is a more cost-effective pneumococcal vaccine compared to PCV13. PCV13 is more effective at preventing severe invasive pneumococcal disease and pneumonia, while PCV10 is better at protecting against ear infection. 

Overall, the responses of the vaccination depends on the age of the receiver and the serotype of pneumococcal. 

How is pneumococcal vaccine given to children?

The latest pneumococcal vaccination offered by the Ministry of Health is given in three doses:

1. First dose at 4-months old

2. Second dose at 6-months old

3. Third dose (booster) at 15-months old

The vaccine is administered through intramuscular injection at the thigh of the babies or the upper arm in young children.

Side effects

Common side effects associated with pneumococcal vaccination include fever, pain and swelling at injection site, as well as irritability. These are mild side effects and should go away within a few days. Other less common side effects are diarrhoea, rashes, and reduced appetite. However, if your children develop rare but serious allergic reactions, such as difficulty in breathing, visit the emergency department immediately.

If your children have certain medical conditions, such as congenital disease or cancer, consult a doctor first before administering any vaccine. Generally, immunocompromised children such as those with certain cancers, HIV infection and chronic heart diseases are encouraged to receive pneumococcal vaccination to protect them from invasive pneumococcal disease. 

A word from DOC2US

If you have any questions related to pneumococcal disease and its vaccine, you can consult our professional doctors and healthcare professionals on DOC2US. DOC2US is a mobile application that allows you to talk to a doctor or any healthcare professionals via text chat at any time and from anywhere. For better communication, you can even send our online doctor images or voice messages related to your medical inquiry.

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Disclaimer: As a service to our users and general public, DOC2US provides health education contents. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Specific references have been linked in its relevant part of the article. 

Cover image credit: Photo by Amanda Mills, USCDCP on Pixnio
 

Written by

Ms Joyce Toh