Pneumococcal Vaccination in Adults
- Author:
Lee Gan Goh
1
Author Information
- Collective Name:Paul Anantharajah Tambyah
- Publication Type:Journal Article
- Keywords: Pneumonia; community acquired pneumonia; non-invasive; pneumococcal; disease; invasive
- From:The Singapore Family Physician 2018;44(2):14-22
- CountrySingapore
- Language:English
- Abstract: Pneumonia is an important cause of mortality and morbidity worldwide including Singapore. It imposes heavy economic burdens on health care systems. S. pneumoniae is an important pathogen in community acquired pneumonia (CAP) in both developed and developing countries. Pneumococcal disease is importantly, vaccine preventable. The objectives of this review are to provide updates on: pneumococcal disease in adults; pneumococcal vaccines for adults; the need to increase uptake of pneumococcal vaccines; and recommendations on pneumococcal vaccinations in the current national adult immunization schedule. Pneumococcal disease in adults can be divided into invasive and non-invasive pneumococcal diseases. Two pneumococcal vaccines are currently available for adult vaccination in Singapore, namely, the 23-valent pneumococcal polysaccharide vaccine (PPSV23) and the 13-valent pneumococcal conjugate vaccine (PCV13). The current recommended pneumococcal vaccine immunization strategy is to administer the PCV13 first followed by PPSV23 a year later in pneumococcal vaccine naïve patients. In patients given PPSV23 before, PCV13 is given to complete the protection. Cost effectiveness studies in Singapore have shown that pneumococcal conjugate vaccines may confer protection against pneumococcal disease both directly and indirectly through herd effects, and reduction of nasal carriage. Uptake of pneumococcal vaccines in Singapore is currently low. Characteristics associated with increased pneumococcal vaccination uptake were higher monthly income, higher educational level, having a regular doctor, and good self-rated health. A research-guided educational intervention may be an effective model to improve the knowledge and attitudes of patients towards pneumococcal vaccinations. We need to find ways to use vaccination and other strategies to reduce the mortality and morbidity associated with pneumococcal disease in Singapore.
