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Pneumococcus bacterium often exists in the nasopharynx and is transmitted to other people by cough droplets. It usually does not incur diseases. However, when immunity is lessened, the bacteria may cause many diseases, including pneumonia, sinusitis, otitis media, meningitis, bacteremia, and even severe invasive pneumonia.

Pneumococcal infections are found worldwide, but are more common in developing countries, in crowded places, and flourishes during winter and early spring. These infections pose most danger to infants, elderly people, those with heart and lung diseases, diabetes, or are immunocompromised. Pneumonia ranked the third lead cause of deaths in Taiwan in 2021.

Vaccination suggestions

At present, pneumococcus bacterium has become highly resistant to some antibiotics, so the most effective way to prevent invasive streptococcus pneumoniae infection is to receive pneumococcal vaccines following a strict schedule. At present, there are two kinds of adult pneumococcal vaccines approved and marketed in Taiwan, which are the 13-valent pneumococcal conjugate vaccine (PCV13) and 23-valent polysaccharide vaccine (PPSV23), mainly recommended for elderly aged 65 or older and high-risk individuals between 18 and 65 of age.

• For those who have not received a pneumonia vaccine before the age of 65, it is recommended that one dose of 13-valent vaccine be administered first, and then another dose of 23-valent vaccine be administered one year later (eight weeks later for high-risk groups).
• For those who have been vaccinated with the 23-valent pneumococcal vaccine before 65 years of age, it is recommended that after 65 years of age, one dose of 13-valent vaccine should be administered at least one year after the first dose of 23-valent vaccine, and the second dose of 23-valent vaccine should be given one year later (and at least 5 years apart from the first dose of 23-valent vaccine).
• For those who have been vaccinated with the 23-valent vaccine after 65 years of age, it is recommended that one dose of 13-valent vaccine be supplemented one year later (eight weeks later for high-risk groups).
• High-risk individuals include those in following six categories:

Those with:

1. splenic dysfunction or splenectomy,
2. congenital or acquired immune deficiency (including HIV-infected persons)
3. artificial ear implants
4. chronic nephropathy (including nephrotic syndrome),
5. cerebrospinal fluid leakage
6. malignant tumors and organ transplants recipients under immunosuppressive or radiotherapy.

Possible side effects and vaccine response after injection

• After vaccination, please take a rest under observation for 30 minutes. If there is no discomfort, you may leave hospital.
• Common side effects of the 13-valent pneumococcal conjugate vaccine (PCV13) include local swelling and lumps at the injection site, dermatitis and fever (usually no more than 39℃). Other rare adverse reactions: vomiting and diarrhea.
• The most common side effects of the pneumococcal polysaccharide vaccine (PPSV23) include local pain, rash, warm sensation and hard lumps at the injection site. Other rare side effects include fever, nausea and vomiting.

Reminders

• Pneumococcal vaccines can be administered with other vaccines at different injection sites at the same time or at any time interval. Generally, experts recommend that the pneumococcal vaccine and influenza vaccine be given at different sites at the same time during the flu season, which can effectively lower the occurrence of influenza complications.
• The government-sponsored vaccination time and age limit will vary from year to year. Please pay attention to the announcements made by the Centers for Disease Control, Taiwan and local health bureaus.
• After vaccination, please drink more water and get plenty of rest to reduce discomfort. If you have any questions, please return to the hospital.