PCV (Pneumococcal Conjugate Vaccine)

Key vaccine facts

The PCV used in the UK gives protection against 13 types of pneumococcal bacteria that all cause pneumococcal disease. There are over 90 different types of pneumococcal bacteria, and they cause a range of problems including ear infections and pneumonia (serious chest infections). Pneumococcal disease can also cause life-threatening conditions such as meningitis and septicamia (blood poisoning). Vaccines have been produced to protect against the types that cause the most disease.

The vaccine does not contain any live bacteria and cannot cause pneumococcal disease.

In the UK the PCV is given to all babies at 2, 4 and 12-13 months of age. The repeated doses are needed to give a good immune response in the majority of children. It can safely be given at the same time as other vaccines in the schedule. For more on this, see multiple vaccinations. There is a similar vaccine for older adults (the Pneumococcal Polysaccharide Vaccine).

Pneumococcal vaccines are also recommended for people of all ages with some health conditions who are at greater risk of complications from pneumococcal disease. This includes people with:

  • immunosuppression, a missing spleen, sickle cell anaemia or coeliac disease
  • chronic liver disease, kidney disease or heart disease
  • chronic lung conditions
  • chronic brain (neurological) conditions including learning disability
  • diabetes
  • cochlear implants
  • cerebrospinal fluid leaks
  • complement disorders (the complement system is an important part of the immune system)

The brand name of the PCV used in the UK is Prevenar 13 (see the Patient Information Leaflet ).

In the short film below, Dr Andrew Prendergast talks about pneumococcal disease and why it is important to vaccinate against the disease.

Ingredients

The PCV used in the UK is called Prevenar 13. Apart from the active ingredients (the antigens), it contains very small amounts of these ingredients:

  • aluminium, which strengthens and lengthens the immune response to the vaccine
  • sodium chloride (salt)
  • succinic acid, an acidity regulator
  • Polysorbate, used as an emulsifier (to hold other ingredients together)

The PCV is a conjugate vaccine. Sugars are taken from the capsule around the bacteria and joined to a non-toxic protein from diphtheria. The protein helps to stimulate the immune system in a broader way to respond well to the vaccine. This gives a better immune response in individuals of all ages.

Other brands of the PCV used in other countries may contain different ingredients. If you are not in the UK, ask for the Patient Information leaflet for the vaccine you are offered.

Side effects

Common but not serious (affecting up to 1 in 10 people at each dose):

  • redness, tenderness and/or swelling at the injection site
  • slightly raised temperature
  • irritability
  • loss of appetite
  • drowsiness
  • problems with sleeping

Many of these symptoms can be relieved by giving paracetamol (Calpol) if your child is over 2 months, or ibuprofen if your child is over 3 months and weighs more than 5kg (see NHS Choices for more advice on giving painkillers to babies and children).

Very rare (affecting fewer than 1 in 10,000 people at each dose):

  • high temperatures, sometimes leading to fits (also called convulsions or febrile seizures)
  • mild allergic reactions, or skin rash (hives)

You should consult your doctor if these reactions happen after vaccination. This is mainly to check that it is the vaccine causing the symptoms, and not some unrelated disease.

As with any vaccine, medicine or food, there is a very small chance of a severe allergic reaction (anaphylaxis). Anaphylaxis is different from less severe allergic reactions because it causes life-threatening breathing and/or circulation problems. It is always serious but can be treated with adrenaline. In the UK between 1997 and 2003 there were a total of 130 reports of anaphylaxis following ALL immunisations, but all of these people survived. Around 117 million doses of vaccines were given in the UK during this period, making the overall rate around 1 in 900,000. Depending on the cause of the reaction, and following expert guidance, the person may be able to have vaccinations in the future.

Reactions listed under ‘possible side effects’ or ‘adverse events’ on vaccine product information sheets may not all be directly linked to the vaccine. See Vaccine side effects and adverse reactions for more information on why this is the case.

In the UK you can report suspected vaccine side effects to the Medicines and Healthcare products Regulatory Agency (MHRA) through the Yellow Card Scheme . You can also view data on Yellow Card reports for individual products . See more information on the Yellow Card scheme and monitoring of vaccine safety.

More information about the vaccine

In recent years, there have been several changes to the pneumococcal vaccination schedule in the UK:

  • 2002: a pneumococcal conjugate vaccine protecting against 7 types of pnemococcal bacteria (PCV7) was recommended for
    immunisation of babies and children in at-risk groups under the age of two years
  • 2003: pneumococcal polysaccharide (PPV) immunisation was recommended for all people aged 65 and over
  • 2004: PCV7 was extended to at-risk babies and children under five years of age
  • 2006: PCV7 was added to the routine childhood immunisation programme
  • 2010: a pneumococcal conjugate vaccine protecting against 13 types of pnemococcal bacteria (PCV13) replaced PCV7.

Does the vaccine work?

It is estimated that in the first 11 years of the pneumococcal vaccine programme (2006-07 to 2016-17), the vaccine prevented nearly 40,000 cases of invasive pneumococcal disease, and about 2000 deaths.

The original version of the PCV (Prevenar7) was introduced in 2006. This vaccine protected against seven of the types of bacteria, and resulted in a big reduction in the number of cases of pneumococcal disease in babies caused by these seven types. However, there was an increase in the number of cases caused by other types of pneumococcal bacteria. Six strains in particular were identified as causing most of the new cases of pneumococcal disease.

In 2010, the PCV vaccine was changed to one that protected against 13 types of bacteria (Prevenar13). Research in 2011 by the UK's Health Protection Agency (now Public Health England) showed a big reduction in serious disease caused by the additional six types of pneumococcal bacteria protected against by the new vaccine. Another study by Public Health England published in 2015 confirmed that 8 years of PCV use in England and Wales had reduced the overall incidence of invasive pneumococcal disease by more than 50%. The PCV has a herd immunity effect. Vaccination of babies has reduced the amount of disease in the whole population, because infants and children are no longer carrying so many pneumococcal bacteria and spreading them around.

However, the 2015 research noted that other strains of pneumococcal bacteria were starting to become more common, and could partly replace the strains that are disappearing, especially in non-vaccinated older individuals. Public Health England has continued to monitor this trend. It has found that strains not covered by the PCV have increased, and are causing more cases of pneumococcal disease (over 4000 cases in 2015-16, compared with about 2000 cases in 2010-11). Recent reports can be found here .

At the moment the disease caused by these strains is generally less severe and less likely to be fatal. There is still a very substantial reduction in disease in young children but non-vaccine strains have replaced the reductions in disease in older age groups to some extent. Public Health England is continuing to monitor the situation. Future strategies might include development of vaccines for a wider set of organisms, especially for those causing replacement disease in the elderly.

Page last updated: 
Thursday, August 9, 2018

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