Human Swine Influenza

Pneumococcus - What harm can it do?
Streptococcus pneumoniae (commonly known as Pneumococcus) is a kind of bacteria that may normally be found in the airways of healthy subjects. It may be passed to others via droplets generated by sneezing or coughing, or through contact with objects soiled with nasal or cough discharges. While the germs usually cause a mild infection of the sinus or the middle ear, it can lead to more severe or life-threatening infection of the lungs, blood stream and membranes of the brain, known as invasive pneumococcal diseases (IPD). When this occurs, hearing and brain function damage or even death may result.

Are you at greater risk?
Get the pneumococcal vaccine if you belong to the following high risk groups as recommended by the Scientific Committee on Vaccine Preventable Diseases -

• Children aged between 6 weeks and less than 2 years
• Elderly persons aged 65 years or above
• Persons aged 2 to 64 years who have history of IPD, are immunocompromised, have underlying chronic illnesses, or have cochlear implants

How is pneumococcal vaccine given?
Over 90 pneumococcal serotypes are identified. Two types of pneumococcal vaccines targeting the most common serotypes are currently registered for use in Hong Kong -
23vPPV (23-valent pneumococcal polysaccharide vaccine)
23vPPV vaccine can protect against 23 pneumococcal serotypes. Its effectiveness against IPD among healthy adults is as high as 50-80%. It is suitable for use in people aged two years or above.
Number of Doses

• Persons receiving the first dose at the age of 65 years or above will require only one dose.
• Persons who have history of clinical IPD, are immunocompromised, have underlying chronic illnesses, or have cochlear implants may consider revaccination 5 years after the first dose of 23vPPV.
• It is recommended for any person to receive no more than two doses of 23vPPV.

23vPPV not to be given when

• The person experienced severe allergic reactions after a previous dose of 23vPPV
• The person is receiving chemotherapy or radiotherapy
• The person is pregnant or breastfeeding

PCV7 (7-valent pneumococcal conjugate vaccine)
PCV7 vaccine can protect against 7 pneumococcal serotypes. Evidence shows that PCV7 is more immunogenic than 23vPPV for young children. Hence, it is suitable for use in children aged 9 years or below.
Number of Doses
The number of doses of PCV7 required will depend on the age of the child. Newborns will receive four doses of PCV7 for optimal protection.
PCV7 not to be given when

• The person experienced severe allergic reaction after a previous dose of PCV7
• The person experienced severe allergic reaction to diphtheria vaccine

Side effects are usually mild
Pneumococcal vaccine is safe. Slight swelling and pain at the injection site may occur shortly following injection. If a second dose of 23vPPV is being given, such reactions may be more severe but they will resolve within a few days without treatment.
Children
With effect from September 2009, PCV7 vaccination is given as part of the Childhood Immunisation Programme. Children who were born on or after 1 September 2007 may receive free vaccination at Maternal and Child Health Centres of the Department of Health.
Elderly Persons
From October 2009, persons aged 65 or above may obtain subsidised vaccination from a private medical doctor enrolled in the Elderly Vaccination Subsidy Scheme. Those who are receiving Comprehensive Social Security Assistance, or having chronic illness attending public clinics may receive free influenza and pneumococcal vaccinations through Department of Health or Hospital Authority.

Dual vaccination with seasonal influenza vaccine gives additional protection to the elders
If an elderly person with influenza should get secondary bacterial infection of the chest, this may result in serious illness and even death. Hence, dual vaccination with seasonal influenza vaccine and 23vPPV will lower the risk of hospitalisation and death among elderly persons. These vaccines can be administered at the same time but at different injection sites.

For more information, please visit the Centre for Health Protection website www.chp.gov.hk
or call the 24-Hour Health Education Hotline of the Department of Health 2833 0111.
Source from: Department of Health

VI/vn/No. 59 (Oct-2009)