Pneumococcal disease and vaccination: recent changes to the schedule

The immunisation schedule in the UK frequently changes and this emphasises the need for practice nurses to remain familiar with what the changes are, and why they have occurred. The most recent change to the pneumococcal vaccination schedule at the start of 2020 provides an opportunity to reflect on the significance of this infection. This article also explains how the vaccination schedule has altered over time, detailing the rationale for the most recent change.

Pneumococcal disease is a bacterial infection caused by Streptococcus pneumoniae. It is an encapsulated organism, which increases its virulence, and more than 90 different capsular types (serotypes) have been identified (Public Health England, 2020). It is reported that Streptococcus pneumoniae is frequently found in the nasopharynx of healthy individuals, and the risk of developing disease from this carriage is thought to depend on susceptibility of the individual and invasiveness of the bacteria (Southern et al, 2018). Infection with symptoms is commonly categorised as either non-invasive or invasive disease. Non-invasive disease occurs when the infection spreads locally to the middle ear and sinuses, resulting in otitis media and sinusitis, and more serious invasive disease can cause bacteraemic pneumonia and meningitis (Public Health England, 2020). Higher rates of invasive pneumococcal disease have been observed in the very young, older people, and individuals with impaired immune functioning (Public Health England, 2020). Prior to the introduction of routine vaccination against pneumococcal disease for children, in 2005/2006 there were over 6000 reported cases of invasive pneumococcal disease across all age groups in England and Wales (Ladhani et al, 2018).