Pneumococcal

Pneumococcal disease caused by Streptococcus pneumoniae bacteria. It is usually thought of as a disease of the elderly, but it also takes its toll among our children. In 1998, before a vaccine for children was licensed, about 188 of every 100,000 children younger than 2 years of age developed invasive pneumococcal disease (for instance,  meningitis or blood infections). It is the leading cause of bacterial meningitis in the country, hitting children under 1 year old the hardest. About 200 children died from invasive pneumococcal disease each year. Pneumococcal disease is also a common cause of ear infections. There are about 90 subgroups (serotypes) of the pneumococcal bacterium, but 7 of these have accounted for about 80% of infections among children younger than 6 years of age.

            Pneumococcal disease is spread through the air. It can be spread by anyone who is infected, even if they don’t have symptoms. It is most common during the winter and early spring. All children are susceptible to pneumococcal disease, but some are more susceptible than others, including African Americans, American Indians, Alaska Natives, and children with certain medical conditions such as sickle cell disease or HIV infection, or those who don’t have a functioning spleen.

SYMPTOMS

• Pneumococcal pneumonia is the most common form of bacterial pneumonia. Symptoms include high fever, chills, and a productive cough accompanied by pulmonary pain and breathing difficulties. Pneumococcal pneumonia is frequently associated with bacteremia (i.e., the presence of bacteria in the blood).

• The associated mortality is increased by the presence of pre-existing risk factors such as underlying disease, malnutrition or age.

• Symptoms of pneumococcal meningitis are undistinguishable from those of other bacterial meningitis and include fever, headaches, vomiting, and stiffness of the neck. The associated mortality is high, especially among infants and the elderly.

PNEUMOVAX* 23 (Pneumococcal Vaccine Polyvalent) is a sterile, liquid vaccine for intramuscular or

subcutaneous injection. It consists of a mixture of highly purified capsular polysaccharides from the 23

most prevalent or invasive pneumococcal types of Streptococcus pneumoniae, including the six

serotypes that most frequently cause invasive drug-resistant pneumococcal infections among children

and adults in the United States.1 (See Table 1.) The 23-valent vaccine accounts for at least 90% of

pneumococcal blood isolates and at least 85% of all pneumococcal isolates from sites which are

generally sterile as determined by ongoing surveillance of U.S. data.2

PNEUMOVAX 23 is manufactured according to methods developed by the Merck Research

Laboratories. Each 0.5 mL dose of vaccine contains 25 ìg of each polysaccharide type in isotonic saline

solution containing 0.25% phenol as a preservative.