Pneumococcal disease is a common cause of childhood infections. This is why online forums are full of questions from concerned parents. We answer the most common of them.
Are pneumococci resistant to antibiotics?
Pneumococci are bacteria, so they have a natural ability to become resistant to antibiotics. The overuse and incorrect use of antibiotics has led to a situation where previously harmless and easily curable diseases are becoming an increasing danger. Until a few decades ago, all pneumococci were susceptible to antibiotics. Today, depending on the region of the world, the resistance of pneumococci to antibiotics is increasing, and e.g. in countries where antibiotics have been used and are often used (e.g. in Poland or Great Britain), pneumococcal resistance is high, and e.g. in in Scandinavian countries, where antibiotics are rarely prescribed, relatively less. In Poland, as much as 20 percent. pneumococcal strains are fully resistant to penicillins, and another 10 percent. it is moderately sensitive to this class of antibiotics [1]. As pneumococcal disease becomes difficult to treat, prevention, i.e. vaccination, becomes so important.
Is immunity after vaccination lifelong?
It is not yet known how long pneumococcal vaccination works. This is the result of several facts relating to this vaccination. First, pneumococcal vaccination has only been carried out since 1998, and it has not been sufficient time to observe and study how long the vaccine protects against pneumococcal infection. Secondly, vaccinations are recommended for children up to 5 years of age and for the elderly over 65 years of age. After the age of 5, your baby’s immune system is fully developed and able to protect itself against pneumococci. Therefore, it is very difficult to test whether an older child’s immunity is due to vaccination or whether it is already his or her own defense. Life expectancy of 65-year-olds is relatively short, so it is difficult to speak of “lifelong” protection against pneumococci. This term could be used when vaccination at any age would provide protection against bacteria until old age and death.
Who is most at risk of pneumococcal infection?
Pneumococcal bacteria are the most common bacteria in people whose immune systems are not working properly. Therefore, the problem of pneumococci affects children up to 5 years of age (with the highest number of cases occurring under the age of 2), whose immune system is just developing and is not able to detect and fight germs attacking the child. In addition, the elderly are vulnerable, whose body is already often exhausted and the immune system is no longer working as well as it should, and the body is slowly regenerating. Another group at risk of pneumococcus is people with diseases of the immune system, including those infected with HIV and suffering from AIDS.
What infections does pneumococcus cause?
Pneumococcal disease causes a number of diseases, depending on where it is located:
– acute pneumonia, inflammation of the middle ear, paranasal sinuses,
– meningitis,
Blood infection (bacteraemia),
– sepsis (the so-called sepsis).
Additionally, but less frequently: appendicitis, osteoarthritis, osteomyelitis, cholecystitis, peritonitis, endocarditis, prostatitis, vaginitis, cervical and fallopian tube.
Does vaccination completely protect against pneumococci?
There is no vaccine that protects us against a given pathogen 100%. For now, the aim of vaccination against pneumococci is not to completely eliminate diseases caused by these bacteria, but to avoid the most severe forms of diseases, i.e. invasive pneumococcal disease. There are over 90 types of pneumococci, only some of which cause disease in humans. Vaccines available on the market protect against bacteria, which are responsible for about 80 percent. cases of invasive pneumococcal disease.
In countries where vaccination is common (often already compulsory), the effectiveness of vaccination is very good, which is manifested in a significant reduction in the incidence of infants from invasive pneumococcal disease, severe otitis media or severe pneumonia. In addition, these countries show a reduced carrier of these bacteria (not all people who have pneumococcus will get sick, but will transmit the bacteria to other people), which also reduces the number of cases in children.
Our children are vaccinated against many diseases. Does such a large number of vaccines negatively affect the child’s immune system?
It is true that there are more and more vaccines on the market, but they are very modern and contain far fewer antigens (i.e. the molecules that teach our immune system what dangerous microbes look like to us) than vaccines of older generations. In addition, immunity acquired through contact with a real pathogen is associated with contact with hundreds of thousands of germs, a high probability of disease and subsequent complications after the disease.
What vaccines are available on the Polish market and what is their price?
There are three types of vaccines available on the Polish market, each of which has its own target group. Two groups are conjugated vaccines, which are intended primarily for children, and polysaccharide vaccines, which are intended only for adults.
Conjugated vaccines are prepared in such a way as to stimulate a child’s immature immune system to build a defense system against bacteria. Vaccines are available on the market against 10 and 13 types of pneumococci that cause invasive pneumococcal disease. The number of doses of these vaccines is determined by your doctor, based on the type of vaccine and the age of your child.
Polysaccharide vaccines are older generation vaccines that are currently only used in adults. Vaccination is recommended for people who have a weak immune system (e.g. HIV-infected people, people with AIDS, people after chemotherapy, immunosuppressive therapy or spleen removal). In young children, polysaccharide vaccines are not effective at all.
The cost of conjugated vaccines is about PLN 270-370 for one dose, and the child most often has to take several of them. There is a group of higher risk of developing the disease for whom this vaccination is free. This group includes children from 2 months to 5 years of age who suffer from diabetes, asthma, chronic kidney failure, chronic heart disease or have undergone bone marrow transplantation. The polysaccharide vaccine is much cheaper, costs about PLN 80 and only one dose is given.
When should children be vaccinated?
The newborn baby is protected against pneumococci thanks to the antibodies he gets from the mother. Over time, however, this protection ceases to work, and the child’s immune system is not yet developed enough to defend itself against infection. It is therefore recommended that vaccination is started as early as possible – preferably between 2 and 6 months of age.
[1] Koiuszko S., Białucha A., Gospodarek E. [The drug susceptibility of penicillin-resistant Streptococcus pneumoniae]. „Med Dosw Mikrobiol”. 59. 4, s. 293-300, 2008.