Pneumococcal vaccination program for older Australians – common questions & answers for providers
State and Territory information:
Guidelines about the pneumococcal vaccine program for people over 65 years, including, risk groups, eligibility and side effects.
Who is eligible for free pneumococcal vaccine?
How much invasive pneumococcal disease is there in Australia?
What vaccine is used in this Program?
Guidelines for Providers about the administration of PneumoVax®23
When should patients be revaccinated?
What are the contraindications to pneumococcal vaccine?
What are the possible vaccine side effects?
More information
Who is eligible for free pneumococcal vaccine?
The National Pneumococcal Vaccination Program for Older Australians provides free pneumococcal polysaccharide vaccine for adults aged 65 years or over.In addition, the National Indigenous pneumococcal and influenza immunisation program (NIPII) provides free vaccines, through community controlled Aboriginal Medical Services (AMS), State/ Territory immunisation clinics and general practitioners, for Indigenous people:
- aged over 50; and
- aged 15 to 49 who are at high risk, according to NHMRC recommendations.
How much invasive pneumococcal disease (IPD) is there in Australia?
Invasive pneumococcal disease (normally presenting as meningitis, pneumonia and/or bacteraemia) is most common in children under the age of 2 years and in people over 65 years. In adults, pneumococcal pneumonia is the most common clinical presentation of invasive pneumococcal disease (IPD). In 2004, there were 650 notified cases of IPD in people aged 65 years or over. Of these, 94 deaths were recorded, a case fatality rate of 17%.What vaccine is used in this Program?
The 23-valent pneumococcal polysaccharide vaccine (PneumoVax® 23) is the only pneumococcal vaccine approved for use in adults in Australia.PneumoVax® 23 contains polysaccharides derived from the 23 most frequent or most virulent capsular types of Streptococcus pneumoniae in the USA. These serotypes are also responsible for most IPD cases in adults in Australia.
At least 90% of healthy adults respond to PneumoVax® 23 within 2 to 3 weeks.
The 7-valent pneumococcal conjugate vaccine (Prevenar®) should NOT be used for this Program. Prevenar® is administered to children at 2, 4 and 6 months of age, in accordance with the Australian Immunisation Handbook 9th Edition 2008 (NHMRC).
Guidelines for Providers about the administration of PneumoVax®23
Detailed information on pneumococcal infections and the administration of PneumoVax®23 is contained in Part 3.18: Pneumococcal infections of the Australian Immunisation Handbook 9th Edition 2008 (NHMRC).The vaccine can be administered at the same time as influenza vaccine.
When should patients be revaccinated?
The current recommendation is for non-Indigenous adults 65 years or over to receive a dose of PneumoVax®23, with a single revaccination 5 years later. Revaccination should not be given within 3 years of the previous dose, due to the increased risk of local reactions.Refer to the Australian Immunisation Handbook 9th Edition 2008 (NHMRC).
Part 3.18: Pneumococcal infections for guidance on revaccination for adults who have received the vaccine prior to turning 65 years of age.
What are the contraindications to pneumococcal vaccine?
The only absolute contraindications to pneumococcal vaccine are anaphylaxis after a previous dose of the vaccine or anaphylactic sensitivity to any vaccine components. Relative contraindications affecting the over 65 age group include the recent use of immunosuppressants or radiation of lymph nodes. However, once it is considered that these patients are immunologically ‘stabilised' they should promptly be vaccinated.What are the possible vaccine side effects?
About half the recipients of pneumococcal vaccine will experience some soreness after the first dose, but pain or swelling severe enough to limit arm movement occurs in less than 5% of recipients. Low-grade fever occurs occasionally, but fever above 39 degrees Celsius occurs in less than 0.5% of recipients. A first revaccination is associated with an increase in local adverse events, with about three-quarters experiencing soreness at the injection site, and approximately 10% of recipients experiencing a moderate or greater limitation, albeit temporary, of arm movement. However, revaccination is not associated with an increase in systemic adverse events such as fever or headache. Anaphylaxis after a previous dose or anaphylactic sensitivity to any vaccine components is possible, but very rare.More information
Information about the General Practice Immunisation Incentives (GPII) Scheme is available on the Medicare Australia website, or phone 1800 246 101 (free call - 24 hours).Information about the Australian Childhood Immunisation Register (ACIR) is available on the Medicare Australia website or phone 1800 653 809 (free call).
For technical information refer to the Australian Immunisation Handbook 9th Edition 2008 (NHMRC).
Page last modified: 08 April, 2008