''Another nasty bug for which vaccination should be considered.
ELIZABETH BASSETT, 1 November 2002''
VACCINE UPDATE FOR PARENTS WITH YOUNG CHILDREN
Until recently there has been no effective vaccine to prevent invasive pneumococcal infections in young children. A vaccine called Prevenar is now available in Australia. It is government funded at no cost for children at high risk and available privately for other children.
As reports of the existence of this new vaccine are beginning to appear in the media you may be interested in the following information.
The pneumococcus (also known as Streptococcus pneumoniae) causes meningitis, septicaemia, pneumonia and middle ear infections mainly in young children and the elderly. Children under the age of 2 years are at greatest risk.
Each year in non-Aboriginal Australian children aged less than 5 years the pneumococcus causes approximately 70 cases of meningitis, 630 cases of bacteraemia (blood infection), 1300 cases of hospitalised pneumonia, many thousands of cases of non-hospitalised pneumonia and >40,000 cases of middle ear infection. Between 1993 and 1997 there were 25 deaths in Australian children aged under 4 years from pneumococcal disease.
The pneumococcus causes many more annual cases of meningitis and septicaemia than Meningococcal disease. Between July 1998 and June 2000 there were 1037 hospitalisations for pneumococcal pneumonia, meningitis and septicaemia and 587 for invasive meningococcal disease in Australian children up to 4 years old.
To put all these numbers into perspective, in urban NSW the incidence of the of pneumococcal septicaemia and meningitis in children under the age of 2 years is uncommon and has been recorded at 96 per 100,000 per year.
The incidence in some Aboriginal communities is 20 times greater and is the highest in the world.
The vaccine is not a live vaccine. It provides immunity against the seven serotypes (or strains) most likely to cause the invasive diseases of pneumococcal meningitis and septicaemia. These strains are those most likely to be antibiotic resistant. It may also provide some protection against other strains of which over 90 have been identified.
How effective is the vaccine? The vaccine is highly effective in reducing the risk of invasive pneumococcal disease (meningitis, septicaemia). It is almost 100% effective against the strains in the vaccine and covers about 85% of invasive strains in urban Australian children. It offers some protection against other illnesses caused by pneumococcus including pneumonia and it may also prevent a small proportion of cases of middle ear infection.
The safety of the pneumococcal vaccine has been assessed in large trials in children under the age of 18 months. In the USA, where the vaccine is provided free for all infants under the age of 2 years, more than 12 million doses have been given in the last 2 years. The most frequent side effects are injection site reactions and other minor reactions common to all vaccination. Serious side effects are rare. No vaccine is 100% effective or 100% safe.
Age 2-6 months 3 doses 2 months apart Age 7-17 months 2 doses 2 months apart Age >18 months 1 dose
Timing
The vaccine can be given at the same time as other childhood vaccines including meningococcal vaccine and chickenpox vaccine.
High -Risk Groups eligible for free vaccine
The vaccine is expensive and costs approximately $150 per dose. Note that many private health insurance companies may allow partial reimbursement of the costs of this vaccine.
Sources used for the above article include: Commonwealth Department of Health and Ageing Immunisation service Royal Children�s Hospital Melbourne Wyeth Lederle Vaccines
Useful Web site:
[www.health.gov.au/pubhlth/immunise/pneumoco_a4.pdf]
Or search for Prevenar Australia