by Katie Porterfield
November 29, 2011

What is pneumococcal disease?
Pneumococcal disease is a general term used to categorize infections caused by a type of bacteria called streptococcus pneumoniae. Such infections include pneumonia (a lung infection), pneumococcal bacteremia (a blood infection), meningitis (an infection of the covering of the brain), and otitis media (middle ear infection). Each of these pneumococcal illnesses has specific symptoms:

• Pneumococcal pneumonia causes fever, cough, shortness of breath, and chest pain.
• Pneumococcal meningitis causes stiff neck, fever, mental confusion/disorientation and visual sensitivity to light. Though rare (less than 1 case per 100,000 people each year), pneumococcal meningitis is fatal in about 1 out of 10 cases in children and can also lead to other health problems, including brain damage and hearing loss.
• Pneumococcal bacteremia causes joint pain and chills and may cause some of the same symptoms as pneumonia and meningitis.
• Otitis Media causes ear pain, a red or swollen eardrum, and sometimes sleeplessness, fever, and irritability.

Pneumococcal bacteria spreads from person to person through close contact, typically through respiratory droplets from an infected person’s nose or mouth (from a cough or sneeze, for example). In addition, people, especially children, can carry the bacteria in their throats without being ill, which means they may be contagious without knowing it.

Why should I vaccinate my child?
Before a pneumococcal conjugate vaccine was licensed in 2000, pneumococcal infection caused more than 700 cases of meningitis, 13,000 blood infections, about 5 million ear infections, and about 200 deaths every year in children under 5, according to the Centers for Disease Control and Prevention (CDC). Children under 2 make up the highest general risk group for invasive pneumococcal infections.

The first pneumococcal conjugate vaccine, known as PCV7, protected against seven of the more than 90 strains of pneumococcal bacteria. Since the introduction of the vaccine, severe pneumococcal disease has dropped by almost 80 percent among children under 5. In 2010, PCV7 was replaced by PCV13, a pneumococcal conjugate vaccine that protects against 13 of the strains of pneumococcal bacteria. Though protection from 13 strains of the infectious bacteria may not seem like a lot, the CDC stresses that those 13 strains are responsible for the most severe pneumococcal infections among children. The CDC also points out that some strains of pneumococcal bacteria have become resistant to drugs once used to treat them. As a result, pneumococcal infections can be difficult to treat—a fact that makes the vaccine even more important.

Still, parents should note that pneumonia, ear infections, and meningitis have multiple causes, and PCV13 will only protect children against those infections caused by pneumococcal bacteria (and again, even then, PVC13 only targets 13 types of the more than 90 pneumococcal bacteria). As a result, the vaccine is not a blanket protection against these illnesses. Your child may, for example, still get ear infections (a common childhood illness that three out of four children experience before the age of 3), even if his vaccines are up to date. However, studies have shown that children who are vaccinated have fewer ear infections and require tubes in their ears less often than those who are not vaccinated. In addition, the CDC data cited above indicates that the vaccine is highly effective at preventing severe pneumococcal disease.

How many doses will my child receive?
The pneumococcal conjugate vaccine is typically given as a series of four shots (in the leg).

When is the vaccine given?
The CDC recommends that children receive doses of the pneumococcal vaccine at the following ages:

• 2 months
• 4 months
• 6 months
• 12–15 months

Children who miss their shots at these ages should still get the vaccine, according to the CDC. The number of doses, as well as the intervals between doses, will depend on the child’s age. Parents should consult their child’s health care provider for details.

What are the possible side effects?
Side effects include swelling at the injection site (reported in about 1 out of 3 children) and fever (about 1 out of 3 had a mild fever and about 1 in 20 had a fever greater than 102.2 F). Some children (about half) experience drowsiness, loss of appetite, or redness or tenderness at the injection site. Parents can apply a cool, wet washcloth to the sore area and give acetaminophen or ibuprofen (as directed by your child’s physician) for pain and fever. If symptoms persist, parents should contact their child’s health care provider.

When should I call a doctor?
Though the CDC says serious reactions associated with this vaccine are rare, parents should immediately alert their child’s health care provider if the child experiences difficulty breathing, wheezing, hives, paleness, weakness, a fast heartbeat or dizziness. Such reactions would likely occur within a few minutes to a few hours of receiving the vaccination. Parents should also contact their child’s health care provider if the child has a high fever or displays unusual behavior.

Katie Porterfield is a freelance writer and former magazine editor in Nashville, Tennessee. She is mom to twin boys.