Pneumococcal Disease Risk Groups
Pneumococcal polysaccharide vaccine (PPV) is recommended for adults 65 years and over and at risk groups aged 2 years or over. Pneumococcal conjugate vaccine (PCV) is recommended for infants from 2 months of age as part of the routine childhood immunisation schedule, and for children under 5 years of age in a clinical risk group.1 The immunisation programme aims to protect all those for whom pneumococcal infection is likely to be more common and/or serious, i.e.:
- Infants as part of the routine childhood immunisation programme
- Those aged 65 years and over
- Those aged two months and over in the clinical risk groups listed in the table below.
| Clinical risk group | Examples (decision based on your GP or Practice Nurse's clinical judgement) |
| No spleen, or a spleen that isn't functioning properly (known as asplenia or dysfunction of the spleen) | This also includes conditions such as homozygous sickle cell disease and coeliac syndrome that may lead to splenic dysfunction. |
| Chronic chest problems also known as respiratory disease or chronic lung disease | This includes chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema; and such conditions as bronchiectasis, cystic fibrosis, interstitial lung fibrosis, pneumoconiosis and bronchopulmonary dysplasia (BPD). Children with respiratory conditions caused by aspiration, or a neuromuscular disease (e.g. cerebral palsy) with a risk of aspiration. Asthma is not an indication, unless so severe as to require continuous or frequently repeated use of systemic steroids (as defined in Immunosuppression below). |
| Chronic heart disease | This includes those requiring regular medication and/or follow-up for ischaemic heart disease, congenital heart disease, hypertension with cardiac complications and chronic heart failure. |
| Chronic kidney disease | This includes nephrotic syndrome, chronic kidney failure and kidney transplantation. |
| Chronic liver disease | This includes cirrhosis, biliary atresia and chronic hepatitis. |
| Diabetes | Diabetes mellitus requiring insulin or oral hypoglycaemic drugs. This does not include diabetes that is diet controlled. |
| Immunosuppression | Due to disease or treatment, including asplenia or splenic dysfunction and HIV infection at all stages. Patients undergoing chemotherapy leading to immunosuppression. Individuals on or likely to be on systemic steroids for more than a month at a dose equivalent to prednisolone at 20mg or more per day (any age), or for children under 20kg, a dose of 1mg or more per kg per day. However, some immunocompromised patients may have a suboptimal immunological response to the vaccine. |
| Individuals with cochlear implants | It is important that immunisation does not delay the cochlear implantation. |
| Individuals with cerebrospinal fluid leaks | This includes leakage of cerebrospinal fluid such as following trauma or major skull surgery. |
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1. Department of Health. Immunisation against infectious diseases - The Green Book.
Chapter 25 Pneumococcal.