Question of the Week

Question :
Posted On : 26 Sep 2016
what is the current schedule of pneumococcal vaccine and which one should be used conjugated or unconjugated one.should every kid be immunized with the pneumococcal vaccine .is it necessary.what complications if not immunized.
Expert Answer :
The current schedule of pneumococcal vaccine is to use any conjugated pneumococcal vaccine starting at 6 weeks and a total three primary doses at 6,10 and 14 weeks or 2,4 and 6 months of age as per the National schedule of DPT vaccine followed by another dose at 18 months of age.After the age of two years 23 valent pneumo vaccine can be given as single dose.The seroresponse is always better if conjugate vaccine is started followed by non conjugated vaccine.In routine practice only three primary doses and another dose at 18 months is recommended.Only in high risk cases like sickle cell anemia,Splenectomy,immunocompromised children,CSF leak etc,further doses will be required and every 3-5 years one shot of pneumo23 can be administered. The efficacy of pneumo conjugate 7 valent vaccine available in India has efficacy of about 45 percent as the prevalent starins that are covered is about 45 percent and even with 100 percent vaccine efficacy ,the resultatnt benefit would be roughly 45-50 percent.The conjugate pneumo 13 valent vaccine has been licensed in USA and already trials are in progress in India.Once 13 valent is launched then almost 75 percent of the prevalent Pneumococcal starins in India will be covered and will be a better choice.
Regarding the routine use of this vaccine in National schedule,it is debabtable but whoever can afford the vaccine after expalining the efficacy one can administer the vaccine.
If not immunized one can get invasive pneumococcal disease in the form of meningitis and pneumonia.In all high risk groups the vaccine is definitely recommended and has proven benefit.
Answer Discussion :
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