Pneumococcal vaccine

Question

Dear expert-team,
We would like to have our son (4 ½ years old, diagnosis of CF 1 ½ years ago) vaccinated against Streptococcus pneumoniae, what has not been done until now. The paediatrician is of the opinion that it is advisable to use the polysaccharide vaccine and the conjugate vaccine. I thought that the conjugate vaccine is only used in babies and small children and you do not need this kind of vaccine anymore as soon as the polysaccharide vaccine can be used (which covers a border spectrum of S. pneumoniae anyhow). Please give me some information what is advisable to do. Many thanks!

Answer

Hello!
The German commission for vaccination (STIKO) decided in congruence with the extension of the indication for Prevenar® (conjugate vaccine) for still unvaccinated children at the age of the 3rd until the end of the 5th year of life with an increased health risk (see table 2 of the STIKO recommendations*) to recommend a vaccination with the 7-valent (will say it protects against 7 of the known serotypes) conjugate vaccine first and after a minimum time interval of 2 months a vaccination with the 23-valent polysaccharide vaccine (will say protects against 23 of the known serotypes).
The background of this decision is the expected induction of an improved “immunological memory” by the conjugate vaccine, that in the following can be boostered (intensified) with the polysaccharide vaccine. The resulting 2 months delay of vaccination with the polysaccharide vaccine with a broader protection against serotypes in some children is of secondary importance.
This is an extract of the statement of the STIKO.

Probably the assumptions made above are correct for your child. Therefore it is probably possible after a careful consideration of your doctor in charge to vaccinate with the two vaccines with a time interval of 2 months between them (see above).
Yours sincerely,
PD Dr. med. M. Ballmann

14.12.2007