Immunise Australia Program
Australian Government Department of Health and Ageing
Australian Government Department of Health and Ageing. Immunise Australia Program. Information Line 1800 671 811
Immunise Australia Program. Information Line 1800 671 811

Pneumococcal Disease

Information about pneumococcal disease immunisation funded under the Immunise Australia Program.

Recent changes to recommendations for the revaccination of adults with Pneumovax 23®

The TGA and ATAGI, including the Pneumococcal Working Party, have each completed reviews on the previously reported increase in adverse event notifications following revaccination of adults with Pneumovax 23®.

New advice on the safety, efficacy and effectiveness of the vaccine, Pneumovax 23 issued by the TGA in December 2011 states that revaccination can be undertaken in accordance with the approved Product Information (PI) for this vaccine.

TGA advises that a second dose of Pneumovax 23®: For more information, please see the following link:
http://www.tga.gov.au/safety/alerts-medicine-pneumovax-111223.htm

Revised vaccination recommendations by the ATAGI are outlined below: For more information, please see the following link:
http://immunise.health.gov.au/internet/immunise/publishing.nsf/Content/pneumo23-atagi-statement-cnt.htm

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Recent changes to pneumococcal vaccine for children

Program providing a supplementary dose of Prevenar 13®

Who is eligible to receive a free supplementary dose of Prevenar 13®?

From 1 October 2011 until 30 September 2012 children who are aged between 12 months and 35 months and have completed a primary pneumococcal vaccination course with Prevenar® are eligible to receive a free supplementary dose of Prevenar 13®. Children who have previously received doses of Synflorix are not eligible for a free dose of Prevenar 13®.

The Northern Territory Government is providing a free dose of Prevenar 13® at 18 months for children who have previously received a primary course of Synflorix® or a mixed primary pneumococcal course with Synflorix® and Prevenar®.


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Ongoing pneumococcal program

From 1 July 2011, Prevenar 13® (a 13-valent conjugate vaccine) replaced Prevenar® (a 7-valent conjugate vaccine) on the National Immunisation Program in all states and territories except the Northern Territory. From 1 October 2011 the Northern Territory will replace Synflorix® (a 10-valent conjugate vaccine) with Prevenar 13®.

Prevenar 13® provides protection against an additional six serotypes, which can cause Invasive Pneumococcal Disease (IPD), that are not covered by Prevenar®. This includes disease associated with the increasingly predominant serotype 19A.

How will this change affect children who have already started a course of Prevenar® or Synflorix®?

Children who have received one or two doses of Prevenar® or Synflorix® will complete their course using Prevenar 13®.

Who is eligible to receive free pneumococcal conjugate vaccine?

Pneumococcal conjugate vaccination (Prevenar 13®) will be provided to children at 2, 4 and 6 months of age. A fourth dose may also be provided to medically at risk children at 12 months of age.

Medically at risk children should also receive a dose of 23-valent pneumococcal polysaccharide vaccine (Pneumovax 23®) between 4 and 5 years of age.
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Pneumococcal disease

Pneumococcal disease is caused by the bacterium Streptococcus pneumoniae. Some types of the bacterium are commonly found in the upper respiratory tract (nose, throat and windpipe) of healthy people. The bacterium can spread between people through infected droplets in the air and by touching an infected person. The disease can cause:
Pneumococcal meningitis symptoms may include high fever and headache, which may develop over a few hours or 1 to 2 days. Other symptoms may also include: Pneumococcal pneumonia symptoms may be vague and include fever, coughing and difficulty breathing.

Pneumococcal blood system infections can cause symptoms such as fever, chills, irritability, drowsiness and rash.

Pneumococcal middle ear infections cause ear pain and a red and swollen ear drum, difficulty sleeping, fever and irritability.

Most pneumococcal infections are vaccine preventable. Pneumococcal vaccination is recommended as part of routine immunisation for children, Older Australians and Aboriginal and Torres Strait Islander people. It is listed on the National Immunisation Program (NIP) Schedule and funded under the Immunise Australia Program. To receive pneumococcal immunisation, visit your local doctor or immunisation provider. It is important to note that the vaccine is provided at no cost, however a consultation fee may apply.

Immunisation against pneumococcal disease is achieved using single-disease vaccines. For information about immunisation in your area contact your State or Territory Health Department.

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Pneumococcal immunisation for Older Australians

The National Pneumococcal Vaccination Program for Older Australians commenced in January 2005 and provides free pneumococcal polysaccharide vaccine (Pneumovax23®) to adults aged 65 years or older. People aged 65 years or over should discuss vaccination with their doctor or health care provider.

Adults aged 65 years or over are at higher risk of contracting pneumococcal disease than the rest of the population, with the majority of deaths from this disease occurring in this age group. Every effort should be made to provide a dose to anyone aged >65 years who has not previously received a dose of Pneumovax 23®).

For non-Indigenous adults aged >65 years who do not have any condition that predisposes them to an increased risk of IPD (ATAGI’s advice), a repeat dose of Pneumovax 23® is no longer recommended.

For adults aged ≥65 years who have a condition that predisposes them to an increased risk of IPD (see Table A of the ATAGI advice), a second dose (a single revaccination) of 23vPPV is recommended. This dose is to be given ≥5 years after the first dose. (The recommendation for this population subgroup is unchanged.)

For more information, please see the following link: TGA website – Pneumovax 23® – updated revaccination recommendations

Pneumococcal immunisation for Aboriginal and Torres Strait Islander People

Respiratory diseases are major causes of preventable sickness and death in Aboriginal and Torres Strait Islander communities, with some Aboriginal communities having the highest incidence of invasive pneumococcal disease in the world.

In addition to the standard National Immunisation Program (NIP) Schedule, all Aboriginal and Torres Strait Islander children in Queensland, South Australia and Western Australia will receive a dose of 23-valent pneumococcal polysaccharide vaccine (Pneumovax 23®) between the ages of 18 and 24 months. These children do not require a booster dose of Pneumovax 23® if they receive the supplementary dose of Prevenar 13® between the ages of 12 months and 35 months.

In the Northern Territory, the Territory Government will fund Prevenar 13® at 18 months of age for Aboriginal and Torres Strait Islander children.

Free pneumococcal polysaccharide vaccine (Pneumovax23®) is provided through community controlled Aboriginal Medical Services (AMS), State/Territory immunisation clinics and general practitioners, for Indigenous people who are:
The review undertaken by the TGA and ATAGI (and its Pneumococcal Working Party) on the increase in adverse event notifications and issued new advice on the safety, efficacy and effectiveness of Pneumovax 23® and its place within the National Immunisation Program (NIP) has confirmed previous recommendations on the revaccination of Aboriginal and Torres Strait Islanders with Pneumovax 23®.

For more information, please see the following link: ATAGI Statement Pneumovax 23® – updated revaccination recommendations

For technical information or information about vaccines, refer to the pneumococcal section of the Australian Immunisation Handbook 9th Edition 2008 (NHMRC)

Page last modified: 17 January, 2012