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Am Fam Physician. 2001;63(10):2003-2004

Why should my child get this vaccine?

Pneumococcal disease is a serious disease that causes sickness and death. In fact, it causes about 200 deaths each year in children younger than five years.

Pneumococcal disease is the main cause of bacterial meningitis (an infection of the covering of the brain) in the United States. Each year pneumococcal disease causes many health problems in children younger than five years, including these problems:

  • More than 700 cases of meningitis

  • About 17,000 blood infections

  • About 5 million ear infections

Children younger than two years are at highest risk for serious disease.

Pneumococcus bacteria are spread from person to person through close contact. Pneumococcal infections can be hard to treat because the disease has become resistant to some of the medicines that have been used to treat it. This makes preventing the disease even more important. Pneumococcal conjugate vaccine can prevent pneumococcal disease.

What exactly is the pneumococcal vaccine?

Pneumococcal conjugate vaccine is for use in infants and toddlers. It is good at preventing pneumococcal disease in these children, and it also helps stop the disease from spreading from person to person.

The vaccine's protection lasts at least three years. Because most serious pneumococcal infections strike children during their first two years of life, the vaccine will protect them when they are at greatest risk.

Some older children and adults may get a different vaccine called pneumococcal polysaccharide vaccine. There is a separate Vaccine Information Statement for people getting the pneumococcal polysaccharide vaccine.

Who should get the pneumococcal conjugate vaccine and when?

Two groups of children should get this vaccine:

1. Children younger than two years. All healthy infants and toddlers should get four doses of pneumococcal conjugate vaccine:

  • One dose at two months of age

  • One dose at four months of age

  • One dose at six months of age

  • One dose at 12 to 15 months of age

Children who miss the first dose at two months of age should still get the vaccine. Ask your doctor for more information.

2. Children between two and five years of age. Pneumococcal conjugate vaccine is recommended for children between two and five years of age who:

  • Have sickle cell disease

  • Have a damaged spleen or no spleen

  • Have HIV/AIDS

  • Have other diseases that affect the immune system, such as diabetes or cancer

  • Take medicines that affect the immune system, such as chemotherapy or steroids

This vaccine should also be considered for use in all other children between two and five years of age, but especially those who:

  • Are younger than three years

  • Are Alaska natives, Native Americans or blacks

  • Attend group child care

The number of doses needed depends on the age when the vaccination begins. Ask your doctor for more details.

Pneumococcal conjugate vaccine may be given at the same time as other childhood vaccines.

Are there some children who should not get pneumococcal conjugate vaccine or who should wait until they are older?

Children should not get pneumococcal conjugate vaccine if they had a severe (life-threatening) allergic reaction to a previous dose of the vaccine.

Children who are moderately or severely ill at the time the shot is scheduled should usually wait until they recover before getting the vaccine. Children with minor illnesses, such as a cold, may be vaccinated.

What are the risks from pneumococcal conjugate vaccine?

In clinical trials, pneumococcal conjugate vaccine was associated with only mild reactions:

  • About three out of 10 children had redness, tenderness or swelling where the shot was given.

  • About one out of 10 had a mild fever.

A vaccine, like any medicine, could cause serious problems, such as a severe allergic reaction. The risk of this vaccine causing serious harm or death is extremely small.

What if my child has a moderate or severe reaction? What should I look for?

Look for any unusual condition such as a serious allergic reaction, high fever or unusual behavior. If a serious allergic reaction is going to happen, it will happen within a few minutes to a few hours after the shot. Signs of a serious allergic reaction can include the following:

  • Difficulty breathing

  • Hoarseness or wheezing

  • Hives

  • Paleness

  • Weakness

  • A fast heart beat

  • Dizziness

  • Swelling of the throat

What should I do if my child has a reaction?

  • Call a doctor or take your child to a doctor right away.

  • Tell your doctor what happened, the date and time it happened and when the vaccination was given.

  • Ask your doctor, nurse or health department to file a Vaccine Adverse Event Reporting System (VAERS) form, or call VAERS yourself at 1-800-822-7967.

How can I learn more about this vaccine?

  • Ask your doctor or nurse. They can give you the vaccine package insert or suggest other sources of information.

  • Call your local or state health department immunization program.

  • Contact the Centers for Disease Control and Prevention (CDC):

    Telephone: 1-800-232-2522 or 1-888-443-7232 (English)

    Telephone: 1-800-232-0233 (Español)

    Web site of the National Immunization Program:http://www.cdc.gov/nip

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Copyright © 2001 by the American Academy of Family Physicians.

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