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 PCV can safely be given at the same time as other vaccines in the schedule (see the full UK routine schedule for details of the other vaccines). Read more about multiple vaccinations and why these are not a risk to your baby's immune system. There is a similar vaccine for older adults (the Pneumococcal Polysaccharide Vaccine).

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

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

Who should have the vaccine?

For babies born in the UK after 1st January 2020, the PCV is given at 12 weeks, followed by a booster at 12-13 months. Previously, the PCV was given to babies at 8 and 16 weeks, with a booster at 12-13 months of age. This change means that babies will now receive only two injections (instead of three) at the 8 and 16 week vaccination appointments. This change to the PCV schedule is due to the success of the pneumococcal vaccine programme. High uptake of the PCV has resulted in very low levels of disease caused by pneumococcal bacteria, and the UK Joint Committee on Vaccination and Immunisation (JCVI) agreed that one dose of the vaccine plus a booster should continue to provide good protection for children and the community. See the minutes from the JCVI meeting.

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)

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)

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 (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.

Anaphylaxis

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 extremely serious but can be treated with adrenaline. Health care workers who give vaccines know how to do this. In the UK between 1997 and 2003 there were a total of 130 reports of anaphylaxis following ALL immunisations. Around 117 million doses of vaccines were given in the UK during this period. This means that the overall rate of anaphylaxis is around 1 in 900,000.

More information on side effects

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.

If you are concerned about any reactions that occur after vaccination, consult your doctor. 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 contact the MHRA to ask for data on Yellow Card reports for individual vaccines . See more information on the Yellow Card scheme and monitoring of vaccine safety.

More information about the vaccine

The PCV is a conjugate vaccine (see our page on 'Types of vaccine'). Sugars (polysaccharides) are taken from the capsule around the pneumococcal bacteria and joined to a non-toxic diphtheria protein called CRM197. 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.

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 pneumococcal bacteria, especially for those causing replacement disease in the elderly.

Videos about the vaccine

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

What is Pneumococcal Disease and why do we need a vaccine?

https://www.youtube.com/embed/Vaj3rmDNQEU?wmode=opaque&controls=&rel=0

Pneumococcal meningitis - Sam's story

Sam Willis had pneumococcal meningitis when he was 9 months old, before the vaccine was available. In this film, made when Sam was 11 years old, his father talks about the lasting effects of the disease and the impact on the whole family.