Pneumococcal disease

Background

Pneumococcal infections are defined as invasive or non-invasive according to which area of the body is affected. Invasive pneumococcal disease (IPD) is caused by infection of normally sterile sites, for example, blood and cerebrospinal fluid (CSF).

IPD is a major cause of morbidity and mortality, especially amongst:

  • the very young
  • the elderly
  • those with impaired immunity

Non-invasive forms of the infection commonly cause:

  • middle ear infection (otitis media)
  • worsening of bronchitis
  • pneumonia

As with most infectious respiratory diseases, the numbers of cases of pneumococcal infection peak during winter. Up to 50% of people can carry pneumococci in their nose and throat without developing serious infection.

Streptococcus pneumoniae (S. pneumoniae) is the bacterium responsible for causing pneumococcal infection and is characterised by its outer coat, known as capsular polysaccharide. Different capsular types can be distinguished via a process known as serotyping. There are about 90 different types of pneumococci, about a quarter of which cause serious illness.

For public information on pneumococcal disease, visit NHS Inform.

Guidance

For all infection prevention and control guidance visit the A-Z ​pathogens section of the National Infection and Prevention Control Manual.

Data and surveillance

Vaccination

Two pneumococcal vaccines are available that help to protect against pneumococcal disease.

The pneumococcal polysaccharide vaccine, PPV23, is recommended for many of the same people who receive an annual flu vaccination. Unlike the flu vaccine which is given every year, the pneumococcal vaccine is usually only given once. In 2003, the pneumococcal vaccination for all people aged 65 years and over was introduced, in addition to those aged under 65, with certain underlying conditions. This vaccine offers protection against 23 serotypes of IPD.

In September 2006, the pneumococcal conjugate vaccine PCV7 was introduced into the routine childhood immunisation schedule. In spring 2010, PCV7 was replaced with PCV13 to provide broader protection against more serotypes of S. pneumoniae. PCV13 was initially offered as three doses; primary doses at eight and 16 weeks of age, followed by a booster at 12 to 13 months. From April 2020, the PCV13 schedule changed to a primary dose at 12 weeks followed by a booster dose at between 12 and 13 months. PCV13 offers protection against the following 13 serotypes of S. pneumoniae:

  • 1
  • 3
  • 4
  • 5
  • 14
  • 6A
  • 6B
  • 7F
  • 9V
  • 18C
  • 19A
  • 19F
  • 23F 

To coincide with the introduction of PCV7, enhanced surveillance was established for children under five years of age.

Vaccine uptake statistics

View the most recent PCV13 vaccine uptake statistics.

Vaccine coverage statistics