Pneumococcal Vaccine for Infants Your Complete Guide to Protection and Prevention

Vaccines are the first line of defense for our children against many serious diseases, and the pneumococcal vaccine is one of the most important vaccines that protect infants and children from infections that can cause severe health complications such as pneumonia, middle ear infections, and meningitis.In this article by Dalily Medical, we will talk in detail about the importance of the pneumococcal vaccine, its schedule, and the great benefits it offers in boosting your child’s immunity and keeping them healthy.If you want to know everything about this vaccine and how to protect your child from respiratory diseases, follow along with us step by step.

What is Pneumococcal Disease?

Pneumococcal disease is a bacterial infection caused by a bacterium called Streptococcus pneumoniae (pneumococcus). This bacterium can cause a variety of illnesses, some mild like ear infections, and some very serious like pneumonia and meningitis.

Diseases Caused by Pneumococcal Bacteria:

Pneumonia:
This is one of the most common diseases caused by this bacterium, affecting the lungs. Symptoms include difficulty breathing, persistent cough, and high fever.

Middle Ear Infection (Otitis Media):
An infection affecting the ear, especially in young children, causing severe pain and ear congestion.

Meningitis:
A serious infection of the membranes surrounding the brain and spinal cord. It can cause severe complications such as brain damage and can be life-threatening if not treated quickly.

Sepsis (Blood Infection):
An emergency condition that occurs when the bacteria spread in the bloodstream. It requires urgent medical treatment because it can lead to very serious complications.

Who is Most at Risk of Pneumococcal Disease?

Infants and very young children, due to their weak immune systems.
Elderly people over 65 years, whose resistance to infections decreases.
People with chronic diseases such as diabetes, heart disease, or asthma.
Individuals with weakened immune systems, either due to immune disorders or immunosuppressive medications.

How is Pneumococcal Infection Transmitted?

Pneumococcal infection spreads easily from person to person, mainly through:

Respiratory droplets released by coughing or sneezing, which nearby people breathe in.
Direct contact or touching surfaces contaminated with the bacteria, then touching the nose, mouth, or eyes, allowing the bacteria to enter the body.

Prevention and Treatment of Pneumococcal Disease

Prevention:
The best way to protect your child is through the pneumococcal vaccine. This vaccine significantly reduces the risk of developing serious diseases caused by this bacterium.

Treatment:
If an infection occurs, it is treated with appropriate antibiotics. However, prevention is always better and safer to avoid serious complications.

Can the Pneumococcal Vaccine Cause the Disease?

The answer is no.
The pneumococcal vaccine does not contain live bacteria. Instead, it contains small parts of the bacteria (called antigens) that help the immune system recognize and fight the bacteria if the child is exposed later. Therefore, the vaccine cannot cause pneumonia or any pneumococcal disease.

Components of the Pneumococcal Vaccine

Antigens:
These are parts of the outer coating of the bacteria, made of a complex sugar called polysaccharide, taken from several different strains of pneumococcus. These antigens stimulate the child’s immune system to recognize the bacteria and respond quickly if exposed in the future.

Conjugate Protein (in conjugate vaccines):
In childhood vaccines like PCV13 and PCV10, the antigens are linked to a special protein (called a conjugate protein) to enhance the immune response, especially in young children whose immune systems are still developing.

Additional Components in the Pneumococcal Vaccine

The pneumococcal vaccine also contains other important ingredients to maintain the vaccine’s quality and effectiveness, such as:

Sterile Water:
Used as a base to dilute and hydrate the vaccine.
Preservatives:
Some vaccines may contain preservatives like diphenyl formaldehyde, but most modern vaccines are preservative-free to ensure the safety of children.

What is Pneumococcal Disease?

Pneumococcal disease is a bacterial infection caused by the bacterium Streptococcus pneumoniae (pneumococcus). This bacterium can cause a variety of illnesses, ranging from mild infections like ear infections to severe and potentially life-threatening diseases such as pneumonia and meningitis.

Diseases Caused by Pneumococcus Bacteria:

Pneumonia:
One of the most common diseases caused by pneumococcus, affecting the lungs. Symptoms include difficulty breathing, persistent cough, and high fever.
Middle Ear Infection (Otitis Media):
An infection especially common in young children, causing severe ear pain and congestion.
Meningitis:
A serious infection of the membranes surrounding the brain and spinal cord. It can cause severe complications like brain damage and can be life-threatening if not treated promptly.
Sepsis (Blood Infection):
A medical emergency occurring when the bacteria spread in the bloodstream, requiring immediate treatment as it can lead to severe complications.

Who is Most at Risk of Pneumococcal Disease?

Infants and young children due to their immature immune systems.
Elderly people over 65 years whose immunity declines.
People with chronic illnesses such as diabetes, heart disease, or asthma.
Individuals with weakened immune systems due to immune disorders or immunosuppressive medications.

How Does Pneumococcal Infection Spread?

The infection spreads mainly through:

Respiratory droplets released when an infected person coughs or sneezes, inhaled by people nearby.
Direct contact or touching contaminated surfaces, then touching the nose, mouth, or eyes.

Prevention and Treatment of Pneumococcal Disease:

Prevention:
The best protection is the pneumococcal vaccine. This vaccine significantly reduces the risk of severe pneumococcal diseases.

Treatment:
If infection occurs, it is treated with appropriate antibiotics. However, prevention is always safer and more effective to avoid serious complications.

Can You Get Pneumococcal Disease from the Vaccine?

No.
The vaccine does not contain live bacteria but parts of the bacteria (antigens) that help the immune system recognize and fight the bacteria if exposed later. Therefore, the vaccine cannot cause pneumococcal disease.

Components of the Pneumococcal Vaccine:

Antigens:
These are parts of the bacterial outer capsule, made of complex sugars (polysaccharides) from different strains of pneumococcus. They stimulate the immune system to recognize and respond quickly if exposed to the bacteria.
Conjugate Protein (in conjugate vaccines):
In vaccines like PCV13 and PCV10 given to children, these polysaccharides are linked to a special protein that boosts immune response, especially in young children whose immune systems are still developing.

Additional Components in the Vaccine:

Mineral Salts:
Such as phosphate or sodium chloride, to maintain the vaccine’s pH for safety and effectiveness.
Other Ingredients:
Some vaccines may contain small amounts of aluminum compounds to enhance the immune response.
Sterile Water:
Used as a base to dilute and stabilize the vaccine.
Preservatives:
Some vaccines may contain preservatives like diphenylformaldehyde, though many modern vaccines are preservative-free to ensure safety.

Can You Get Pneumococcal Infection After Vaccination?

While the vaccine does not cover all types of pneumococcal infections, it significantly reduces the risk of severe diseases and lessens their severity if infection occurs. The vaccine protects and reduces complications and severe symptoms.

Who Should Get the Pneumococcal Vaccine?

All infants and young children:
Recommended starting from 2 months old according to immunization schedules to protect against severe diseases like pneumonia, ear infections, and meningitis.
Children at higher risk:
- Those with chronic illnesses like asthma, heart or lung diseases.
- Children with weakened immune systems, such as HIV patients or those receiving chemotherapy.
- Children with spleen problems or those who had their spleen removed.
- Children with chronic liver or kidney diseases.
Children in high-risk environments:
- Those attending crowded daycare centers.
- Those living in areas where pneumococcal disease is widespread.

What is the Pneumococcal Vaccine?

It is an important vaccine that protects children and adults from various types of Streptococcus pneumoniae bacteria. These bacteria spread through respiratory droplets from coughing or sneezing.

If bacteria enter the body, they can cause:

Bloodstream infections (bacteremia), which can be life-threatening.
Bacterial meningitis, a serious infection of the brain membranes.
Pneumonia, causing breathing difficulty and severe symptoms.
Sepsis, a dangerous body reaction to infection that can threaten life.

How Many Pneumococcal Vaccine Doses Do Adults Need?

Adults usually need one or two doses. The exact number and timing depend on age, health status, and risk factors. Your doctor or healthcare provider will recommend the appropriate schedule.

What is Pneumococcal Infection?

Pneumococcal infection refers to a wide range of diseases caused by the Streptococcus pneumoniae bacteria. These infections can be mild, like sinusitis or ear infections, or severe, such as:

Bacterial pneumonia
Blood poisoning (sepsis)
Meningitis

Children and elderly are generally more susceptible to severe complications.

What is Streptococcus pneumoniae (Pneumococcus)?

It is a gram-positive bacterium characterized by its unique appearance under a microscope and covered by a polysaccharide capsule. There are over 100 known serotypes (subtypes) based on the capsule composition.

How Does Pneumococcal Infection Spread?

The bacteria normally live in the upper respiratory tract of many healthy people but can spread when an infected person coughs or sneezes, releasing droplets into the air, which others may inhale.

Transmission can also occur via direct contact or indirectly by touching contaminated surfaces or objects.

Pneumococcal Disease Rates in Hong Kong:

Between 2018 and 2022, pneumococcal invasive disease incidence ranged approximately from 0.34 to 2.54 cases per 100,000 people annually in Hong Kong. Children aged 2 to 4 years and elderly over 65 years were the most affected groups.

Serotype 3 was the most prevalent, accounting for about half of cases from 2015 to 2019.

How is Pneumococcal Disease Treated?

Treatment usually involves the use of appropriate antibiotics. Unfortunately, some pneumococcal strains have developed resistance, complicating treatment.

Therefore, prevention remains crucial to reduce infection risk and complications.

Does Previous Infection Protect Against Future Infection?

No, because pneumococcus has over 100 different serotypes. Infection with one type does not guarantee immunity against others, so reinfection by different strains is possible.

How to Prevent Pneumococcal Infection?

Vaccination: The most effective method, especially for children, elderly, and those with chronic illnesses.
Personal hygiene: Regular handwashing and covering mouth when coughing or sneezing.
Healthy lifestyle: Balanced diet, regular exercise, and adequate sleep to strengthen immunity.
Avoid smoking: Smoking damages respiratory defenses and increases infection risk.

Following these measures helps protect you and your family from serious pneumococcal diseases.

For Those Not Covered by Government Vaccination Programs:

If you are not included in your country’s government pneumococcal vaccination program, you can choose any officially registered pneumococcal vaccine according to manufacturer recommendations and after consulting your healthcare provider.

Who Are Considered High-Risk Groups?

Individuals with a history of invasive pneumococcal disease or cerebrospinal fluid leaks.
Cochlear implant recipients.
Patients with chronic heart, vascular (excluding uncomplicated hypertension), lung, liver, or kidney diseases.
People with metabolic diseases like diabetes or obesity (BMI ≥ 30).

People with weakened immunity due to conditions such as asplenia (absence of the spleen), HIV/AIDS, or those receiving chemotherapy or steroids:
They are at higher risk and need special attention when considering pneumococcal vaccination.

Those with chronic neurological diseases affecting breathing or the body's ability to handle secretions, or those unable to care for themselves properly:
These individuals also fall into high-risk categories.

Why do elderly people need both the flu vaccine and the pneumococcal vaccine?
Secondary bacterial pneumonia is one of the main causes of illness and death among elderly people who get the flu.
Local studies have shown that receiving both the flu vaccine and the pneumococcal vaccine together significantly reduces the risk of hospitalization and death in the elderly.

Can the pneumococcal vaccine be given at the same time as the flu vaccine?
Yes, it can. However, the vaccines must be administered as separate injections at different sites on the body to ensure the best immune response.

Can the pneumococcal vaccine be given together with the COVID-19 vaccine?
Yes, the COVID-19 vaccine can be given at the same time as, before, or after the pneumococcal vaccine, provided there is medical approval and the person understands the information about both vaccines.

Should the pneumococcal vaccine be given before or after certain medical procedures?
If planning to have a spleen removal (splenectomy), it is best to get vaccinated at least two weeks before the surgery if possible.
For those undergoing chemotherapy or radiation therapy, it is preferable to get vaccinated before or after treatment, but sometimes vaccination during treatment may be necessary depending on the patient’s condition.

What are the possible side effects after receiving the 23-valent pneumococcal polysaccharide vaccine (23vPPV)?
After receiving 23vPPV, you might experience mild swelling or slight pain at the injection site, usually disappearing within two days.
Rarely, fever, muscle pain, or more severe reactions at the injection site may occur.
The vaccine is very safe, but if you notice abnormal symptoms such as:

Persistent fever
Difficulty breathing
Swelling of lips or tongue
Rash or severe itching
You should consult a doctor immediately.

What are the side effects after receiving the 15-valent pneumococcal conjugate vaccine (PCV15)?
In children under two years old, the most common side effects are:

Fever
Irritability or fussiness
Sleepiness
Pain at the injection site
In adults, common side effects include:
Pain at the injection site
Fatigue
Muscle aches
Headache
The vaccine is safe, but if severe or unusual symptoms appear, such as difficulty breathing, swelling, or rash, contact your doctor immediately.

Who is not eligible to receive pneumococcal vaccines?
People who have had severe allergic reactions or hypersensitivity to a previous dose of pneumococcal vaccine or any of its components, or to vaccines containing diphtheria toxoid, should not receive further doses of this vaccine.

Can you get the pneumococcal vaccine if you have a mild illness on the vaccination day?
Mild illnesses such as common colds or mild upper respiratory infections are not contraindications for vaccination.
However, if you are worried or your symptoms are severe, you may postpone vaccination until you feel better and are in good health.

Vaccination schedule for seniors (65 years and older) in the government pneumococcal vaccination program:
The Hong Kong government vaccination program offers free or subsidized pneumococcal vaccine to seniors aged 65 and above.

If the person does not have any high-risk conditions, they receive a single dose of the 23-valent pneumococcal polysaccharide vaccine (23vPPV).
If the person has high-risk conditions, they receive one dose of the 15-valent pneumococcal conjugate vaccine (PCV15), followed one year later by a second dose of 23vPPV.

What are pneumococcal vaccines?
Pneumococcal vaccines protect against infections caused by Streptococcus pneumoniae bacteria, which can cause serious illnesses such as:

Pneumonia
Middle ear infection (otitis media)
Meningitis (infection of the brain and spinal cord membranes)
Blood infections (sepsis)

Which children and infants might not be eligible for pneumococcal vaccination?

Children with severe allergies to any component of the vaccine.
Children who had a severe allergic reaction (e.g., rash, difficulty breathing, swelling of face or throat) after a previous dose of the same vaccine should avoid further doses.
Infants with severe acute illness or high fever should postpone vaccination until recovery.
Children with a history of severe allergies to other vaccines should consult a doctor before vaccination.
Rarely, some children with immune system problems may not be able to receive certain vaccines; however, pneumococcal vaccines are not live vaccines, so it is uncommon to be contraindicated.

How Do Pneumococcal Vaccines Work?

Pneumococcal vaccines contain safe parts of the bacteria, such as a piece of the outer coating or a specific protein. The immune system recognizes these parts and starts building defenses against them.

So, when the child encounters the actual bacteria in the future, their body can quickly fight it off and prevent illness.

Types of Pneumococcal Vaccines:

Conjugate Vaccines: Such as PCV13 and PCV10. These are very suitable for children and cover specific types of pneumococcal bacteria.
Polysaccharide Vaccine: Such as PPSV23, mostly used for adults or special cases.

Benefits of Pneumococcal Vaccine for Children and Infants:

Protection from Serious Diseases: The vaccine protects your child from infections that can cause illnesses like pneumonia, middle ear infections, and meningitis.
Reduced Risk of Complications: It lowers the chance of serious complications like brain damage or hearing loss resulting from infections.
Prevention of Disease Spread: It decreases the chances of bacteria spreading among children, especially at home and school.
Protection for High-Risk Children: Children with weakened immune systems or chronic diseases are more vulnerable, and the vaccine boosts their resistance.
Reduced Need for Antibiotics: Preventing infections means fewer antibiotic treatments, which helps reduce antibiotic resistance.
Enhanced Natural Immunity: The vaccine activates the immune system to quickly recognize and deal with the bacteria if exposed.

Differences Between Pneumococcal Vaccines for Children/Infants and Adults:

Aspect	Children/Infants Vaccines (PCV10, PCV13)	Adults or Special Cases Vaccines (PPSV23)
Target Groups	Children from 2 months to 5 years	Older adults above 65 years and people with chronic illness or weak immunity
How It Works	Conjugate vaccine strengthens immunity in young kids	Polysaccharide vaccine for adults or immune-compromised individuals
Number of Covered Strains	Covers 10 or 13 common strains in children	Covers 23 strains but less effective in young children
Benefits for Children	Protects against severe respiratory infections, ear infections, and meningitis	Not usually given to children due to lower immune response
Duration of Protection	Long-lasting immunity with booster doses	Protection is limited; boosters often needed
Immune Response	Strong immune response due to protein linkage	Weaker response because it only contains carbohydrate parts

How Is Pneumococcal Vaccine Given to Children and Infants?

Injection Site:

For infants: the injection is given in the front thigh muscle (middle part of the thigh).
For children older than one year: it can be given in the upper arm muscle (deltoid muscle).

Administration Method:

The child should be calm and stable during the injection.
The injection site is cleaned with antiseptic alcohol.
Use a needle appropriate for the child’s size (short and thin).
The vaccine is injected slowly into the muscle.

Post-Vaccination Monitoring:

It is recommended to observe the child for 15 minutes in the clinic for any rare allergic reactions.
The child can be soothed by breastfeeding or playing after vaccination.

Managing Pain and Discomfort:

Applying a cold compress on the injection site can help reduce pain or swelling.
If the child has fever or discomfort, a fever reducer like paracetamol can be given after consulting a doctor.

Types and Importance of Pneumococcal Vaccines for Children and Infants

Pneumococcal vaccines are essential for protecting children from serious diseases such as pneumonia, ear infections, and meningitis. Different vaccines are available depending on the child’s age and health status.

Pneumococcal Vaccine Types Table:

Vaccine Name	Number of Covered Strains	Target Group	Additional Information
PCV13 (Prevnar 13)	13 strains	Children aged 2 months to 5 years	The most widely used worldwide; given in doses according to the official immunization schedule
PCV10	10 strains	Infants up to 5 years in some countries	Safe and effective alternative to PCV13 in some countries
PPSV23 (Pneumovax 23)	23 strains	Elderly, adults, and some children with chronic illnesses	Not used for healthy children; given only in special cases

Which Children Should Receive the Pneumococcal Vaccine?

Healthy Children:

Receive PCV13 or PCV10 as part of the routine vaccination schedule.
The first dose starts at 2 months of age, with booster doses given later.

⚠️ Children at Risk:
Children with conditions such as:

Immunodeficiency
Chronic heart or lung diseases
Severe asthma
may require additional doses or a combination of PCV13 and PPSV23, depending on the doctor’s evaluation.

Why Is It Important to Record Vaccinations?

Every child should have a vaccination record that includes:

Vaccine name
Date of administration
Batch number (vaccine lot number)

This helps track vaccine schedules and ensures the child receives all doses on time.

Pneumococcal Vaccination Schedule for Children and Adults:

Age Group	Vaccine Type	Number of Doses	Vaccination Timing
Infants 2 to 6 months	PCV13	3 doses + booster	At 2 months, 4 months, 6 months + booster at 12–15 months
Children 7 to 11 months	PCV13	2 doses + booster	Two doses spaced two months apart + booster at 12–15 months
Children 12 months to 5 years	PCV13	Single dose	Given if the child was not vaccinated previously
Adults 65 years and older	PCV15 or PCV20 + PPSV23	1 or 2 doses	PCV15 or PCV20, then PPSV23 after one year (depending on condition)
People with chronic diseases or immunodeficiency	PCV13 or PCV15 or PCV20 + PPSV23	Depends on health status	Doctor decides the appropriate schedule based on condition

Important Notes Before Your Child Gets the Pneumococcal Vaccine:

General Health:
If the child has a high fever or severe illness, it’s better to postpone vaccination until recovery.
Mild cold or runny nose is usually not a problem.
Chronic Conditions:
Inform the doctor if your child has asthma, heart disease, or immune problems to get the best vaccine type and schedule.
Allergy History:
Tell the doctor if your child has allergies to any vaccine components or had a severe allergic reaction to any vaccine before.
Vaccination History:
Inform the doctor about previous vaccines to avoid overlapping doses and make a precise schedule.

After Vaccination: What to Expect

It’s normal for your child to experience:

Mild redness or swelling at the injection site
Slight fever or mild tiredness
Minor pain at the injection spot

These symptoms usually go away within 48 hours. You can apply a cold compress and give paracetamol after consulting the doctor if fever or discomfort occurs.