Pneumococcus (or pneumococcal bacteria) causes pneumococcal infections. Although infected individuals usually only experience milder conditions such as sinusitis and ear infections, it can also cause serious and even fatal invasive pneumococcal disease such as pneumonia entering the bloodstream, septicaemia and meningitis, particularly in young children and the elderly.
According to data, 2- to 4-year-olds and individuals aged 65 and over have higher incidences of invasive pneumococcal disease. Coupled with the fact that it has a more severe impact on these two groups, it is highly encouraged for them to get vaccinated against pneumococcal disease to help prevent infection. However, there are many types of pneumococcal vaccines available, so how should you choose?
Types of pneumococcal vaccine
Pneumococcal vaccines can be divided into two main categories, which are
- Pneumococcal conjugate vaccines: 13-valent pneumococcal conjugate vaccine (13-valent vaccine), 15-valent pneumococcal conjugate vaccine (15-valent vaccine), 20-valent pneumococcal conjugate vaccine (20-valent vaccine)
- Pneumococcal polysaccharide vaccine: Pneumococcal polysaccharide vaccine, 23-valent (PPSV23)
13-valent, 15-valent and 20-valent vaccines contain capsular polysaccharide antigens of pneumococcal serotypes conjugated to protein carriers, while the 23-valent vaccine contains purified capsular polysaccharide antigens of twenty-three serotypes.
| Pneumococcal vaccine name | Vaccine composition |
| 13-valent vaccine | Containing 13 capsular serotypes (1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F and 23F) |
| 15-valent vaccine | Containing 15 capsular antigens (1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 22F, 23F, 33F) |
| 20-valent vaccine | Containing 20 capsular serotypes (1, 3, 4, 5, 6A, 6B, 7F, 8, 9V, 10A, 11A, 12F, 14, 15B, 18C, 19A, 19F, 22F, 23F, 33F) |
| 23-valent vaccine | Composed of pneumococcal capsular polysaccharides from 23 serotypes of *Streptococcus pneumoniae*. |
Who should get the pneumococcal vaccine?
It is recommended that infants and people aged 65 and over, or those at high risk, should get the pneumococcal vaccine.
- Young children under 2 years old
Administered as part of the Hong Kong Childhood Immunisation Programme with the 13-valent vaccine, consisting of 2 primary doses at 2 and 4 months of age, and a booster dose at 12 months of age.
- Individuals aged 2 and above with high-risk conditions*
Individuals aged 2 or over with high-risk conditions* should receive a dose of the 13-valent vaccine, followed by a dose of the 23-valent vaccine one year later.
*Individuals in high-risk situations include:
a. Previous invasive pneumococcal disease;
b. Impaired immune function:
- Asplenia, AIDS, primary immunodeficiency;
- Immunodeficiency relating to cancer and organ transplantation;
- Immunodeficiency associated with immunosuppressants or steroids.
c. Chronic illnesses
- Chronic heart, lung, liver or kidney disease
- Diabetes or cerebrospinal fluid leakage;
d. Fitted with a cochlear implant
- People aged 65 and over
You should receive one dose of the 13-valent pneumococcal conjugate vaccine (PCV13) or one dose of the 23-valent pneumococcal polysaccharide vaccine (PPSV23).
What's the difference between the 15-valent and 20-valent vaccines? Which type of pneumococcal vaccine is suitable for me?
How should one choose a pneumococcal vaccine, particularly the 15-valent and 20-valent vaccines, which are often confused due to similar functions and target populations? According to data, the 13-valent, 15-valent, and 20-valent vaccines have similar safety profiles. All three offer overall protection against invasive pneumococcal disease, but their performance differs in detail.
Indirect data indicate that the 15-valent vaccine elicits a stronger immune response against serotype 3 of Streptococcus pneumoniae than the 20-valent vaccine.Clinical studies have shown that, in healthy adults aged 50 or over, the 15-valent vaccine produces an immune response to serotype 3 that is 60% higher than that of the 13-valent vaccine; whilst in healthy infants and young children, the immune response to serotype 3 is 73% higher.However, there is currently no concrete evidence from clinical data available worldwide.
At the same time, the 15-valent vaccine induced a 771 TP3T higher level of opsonophagocytic activity (OPA) against serotype 3 than the 20-valent vaccine.
Although clinical effectiveness and impact require further evidence, research indicates that the 15-valent vaccine may be more effective in preventing invasive pneumococcal infections caused by Streptococcus pneumoniae serotype 3. Consequently, the Department of Health announced in September 2023 that the 15-valent pneumococcal vaccine would be officially adopted for the Hong Kong Childhood Immunisation Programme and the Pneumococcal Vaccination Programme, replacing the 13-valent vaccine.
As for20The vaccine is currently the most broadly protective pneumococcal conjugate vaccine on the market, offering reliable safety and overall protection against invasive pneumococcal disease, with more serotypes providing broader coverage than15The price is more favourable, and it is also more suitable for infants and young children, chronically ill patients, smokers, frequent travellers, and the elderly.
Aside from that,2Over 18s(Including children and adults)，20The price only requires one jab to induce long-lasting immune memory, with no need for booster shots.。
As for infants and young children, they are also suitable for vaccination20The vaccine, suggested6周 – 15Month-old infants require a total of4Needle20vaccine, research data shows that a total of four doses have been administered4針20Vaccines offer better protection for young children and reduce cumulative incidence.10%and reduce hospitalisation rates25%。
23Conjugate vaccines contain more serotypes, which theoretically offer broader protective coverage and can prevent invasive pneumococcal disease, but their effectiveness against non-invasive pneumococcal pneumonia is not ideal.
| Vaccine | 13-valent vaccine | 15-valent vaccine | 20-valent vaccine | 23-valent vaccine |
| Suitable for |
|
|
|
|
| Advantage |
|
|
|
|
However, the specific vaccine to be administered will vary depending on an individual's health and physical condition. It is recommended to consult with a doctor before making a decision.
Side effects of pneumococcal vaccine
After receiving the pneumococcal vaccine, certain adverse reactions may occur.
- Possible side effects of pneumococcal conjugate vaccines (13-valent, 15-valent or 20-valent vaccines)
- Slight swelling and pain at the injection site
- Slight fever
- Irritation
- Fatigue
- Headache,
- Shivering
- Muscle pain
- Drowsiness
The most common side effects in children under two years old are fever, irritability, drowsiness, and pain at the injection site, while in adults, the most common side effects are pain at the injection site, fatigue, muscle pain, and headache.
- Possible side effects of the 23-valent vaccine
- Slight swelling and pain at the injection site
- Fever
- Muscle pain
A gentle reminder that if you experience ongoing symptoms after vaccination, such as a fever, severe allergic reactions (e.g., hives, difficulty breathing, swelling of the lips or tongue), or other adverse reactions, please seek medical attention promptly.
Actually, all vaccines are effective vaccines that can prevent infections caused by *Streptococcus pneumoniae*. The choice of vaccine simply depends on your individual health status and lifestyle needs. If you are considering getting a pneumococcal vaccine, please consult your doctor before making a final decision.
