Kinetics：About Pneumococcal

About Pneumococcal

Pneumococcal infection represents a wide range of diseases caused by the bacterium Streptococcus pneumoniae (or more commonly referred as pneumococcus). While pneumococcus is a common cause of mild illnesses such as sinus or middle ear infections, it may also cause severe or even life-threatening invasive pneumococcal diseases (IPD) such as bacteremic pneumonia, sepsis, and meningitis. The outcomes for IPD are usually more severe among young children and elderly persons.

Pneumococci are carried on human bodies. They are present in the upper respiratory tracts even in some healthy carriers. The bacteria can be transmitted via spread of droplet, direct oral contact or indirect contact with articles soiled with respiratory discharges.

How can invasive pneumococcal diseases be prevented?

One of the most effective means of preventing pneumococcal diseases is by pneumococcal vaccination. The public should also maintain good personal and environmental hygiene practices, balanced diet, regular exercise, adequate rest, and no smoking.

Who should get pneumococcal vaccines?

The Scientific Committee on Vaccine Preventable Diseases (SCVPD) recommends children under 2 years of age to receive pneumococcal conjugate vaccines (PCV) under the Hong Kong Childhood Immunisation Programme (HKCIP). The standard regimen includes a primary series of 3 doses at 2, 4 and 6 months and a booster dose at 12-15 months.

SCVPD recommends high-risk individuals* aged 2 years or above to receive a single dose of 13-valent pneumococcal conjugate vaccine (PCV13), followed by a single dose of 23-valent pneumococcal polysaccharide vaccine (23vPPV) 1 year later. For those who have already received 23vPPV, a single dose of PCV13 should be administered 1 year after previous 23vPPV vaccination. For those who have already received PCV13, a single dose of 23vPPV should be administered 1 year after previous PCV13.

For elders 65 years of age and older without high-risk conditions*, SCVPD recommends either a single dose of PCV13 or a single dose of 23vPPV.

*High-risk conditions include:

(a) History of invasive pneumococcal disease

(b) Immunocompromised states: - Asplenia, HIV /AIDS , primary immunodeficiency - Immunodeficiencies related to malignancies and transplantation - Immunodeficiencies related to use of immunosuppressive drugs / systemic steroid

(c) Chronic disease - Chronic cardiac, pulmonary, liver or renal disease - Diabetes mellitus or Cerebrospinal fluid leakage

(d) With cochlear implants

(Essential hypertension per se is not considered as a high-risk condition)

Different factors such as age and clinical condition may affect the risk of pneumococcal disease. Patients with high-risk conditions should discuss with their attending doctors on the most appropriate vaccination regimen.

Remarks: Under the Government Vaccination Programme and Vaccination Subsidy Scheme, aside from the above list of high-risk conditions, elders 65 years or above with chronic metabolic diseases, obesity (BMI 30 or above), chronic neurological conditions or those with financial difficulties are eligible for free/subsidised pneumococcal vaccination. Please see annex for the list of high-risk conditions eligible for free / subsidized PCV 13 under Government Vaccination Programme and Vaccination Subsidy Scheme.

Annex: List of high-risk conditions eligible for receiving free / subsidized 13-valent pneumococcal conjugate vaccine (PCV13) under Government Vaccination Programme and Vaccination Subsidy Scheme 2020/21.

history of invasive pneumococcal disease, cerebrospinal fluid leakage or cochlear implant
chronic cardiovascular (except hypertension without complication), lung, liver or kidney diseases
metabolic diseases including diabetes mellitus or obesity (Body Mass Index 30 or above)
immunocompromised states related to weakened immune system due to conditions such as asplenia, HIV/AIDS or cancer/steroid treatment

Source: Centre for Health Protection
last update：3 Sept 2020