This section is part 2 of the PHE pneumococcal guideline summary.
Contents included in this summary
Contents not included in this summary
Pneumococcal polysaccharide vaccine (PPV)
Pneumococcal conjugate vaccine (PCV)
There are three types of pneumococcal vaccine licensed in the UK:
- pneumococcal polysaccharide vaccine (PPV) contains purified capsular polysaccharide from each of 23 capsular types of pneumococcus (PPV23) 1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F, 33F
- pneumococcal conjugate vaccine (PCV13) contains polysaccharide from thirteen common capsular types 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F. These are conjugated to protein (CRM197) using similar manufacturing technology to that used for Haemophilus influenzae type b (Hib) and meningococcal conjugate vaccines
- The pneumococcal polysaccharide and pneumococcal conjugate vaccines do not contain thiomersal. The vaccines are inactivated, do not contain live organisms and cannot cause the diseases against which they protect
- pneumococcal conjugate vaccine (PCV10) contains polysaccharide from ten common capsular types 1, 4, 5, 6B, 7F, 9V, 14, 18C, 19F, 23F. These are conjugated to protein D (derived from non-typeable Haemophilus influenzae) or tetanus toxoid or diphtheria toxoid carrier proteins. PCV10 is not currently used in the UK immunisation programme.
Vaccines should be stored in the original packaging at +2°C to +8°C and protected from light. All vaccines are sensitive to some extent to heat and cold. Heat speeds up the decline in potency of most vaccines, thus reducing their shelf life. Effectiveness cannot be guaranteed for vaccines unless they have been stored at the correct temperature. Freezing may cause increased reactogenicity and loss of potency for some vaccines. It can also cause hairline cracks in the container, leading to contamination of the contents.
PCV10, PCV13 and PPV23 are supplied as single doses of 0.5ml.
PCV 10 and PCV13
Storage can cause the vaccine to separate into a white deposit and clear supernatant. The vaccine should be shaken well to obtain a white homogeneous suspension and should not be used if there is any residual particulate matter after shaking.
The polysaccharide vaccine should be inspected before being given to check that it is clear and colourless.
Vaccines must not be given intravenously.
Dosage and schedule
For infants under one year of age:
- first dose of 0.5 ml of PCV13 at eight weeks of age
- second dose of 0.5 ml at 16 weeks of age (at least two months after the first dose)
- a third dose of 0.5 ml should be given after their first birthday (at least 2 months after the last PCV13 dose)
Unimmunised or partially immunised children aged one year and up to two years of age:
- a single dose of 0.5 ml of PCV13
- children and adults in a clinical risk group (table 1)
- see recommendations below
Adults over 65 years and at-risk groups aged two years or over:
- a single dose of 0.5 ml of PPV23
Not currently recommended in the UK National Immunisation Programme.
See the SPC for potential dosing schedules.
Vaccines are routinely given into the upper arm in children and adults or the anterolateral thigh in infants under one year of age. This is to reduce the risk of localised reactions, which are more common when vaccines are given subcutaneously. However, for individuals with a bleeding disorder, vaccines should be given by deep subcutaneous injection to reduce the risk of bleeding.
Pneumococcal vaccines can be given at the same time as other vaccines such as DTaP/IPV/ Hib/HepB, 4CMenB, MMR, MenC, Hib/MenC and influenza. The vaccines should be given at separate sites, preferably in different limbs. If given in the same limb, they should be given at least 2.5cm apart (see Chapter 11). The site at which each vaccine was given should be noted in the individual’s records.
Equipment used for vaccination, including used vials, ampoules or syringes, should be disposed of by placing it in an approved, puncture-resistant ‘sharps’ box according to local authority regulations and guidance in Health Technical Memorandum 07-01: Safe management of healthcare waste.
full guideline available from…
Public Health England. Pneumococcal: the green book, chapter 25. January 2018.
Contains public sector information licensed under the Open Government Licence v3.0.
First included: May 2019.