Pneumococcal vaccination in babies: useful or not?

Pneumococci are germs that are part of the oral flora of every second person. They are transmitted by droplet infection and are responsible for the majority of bacterial infections in children. Here you can find out what speaks for a pneumococcal vaccination and what you should consider.

The germ Streptococcus pneumoniae is found in half of all people in the oral mucosa and is the trigger of pneumococcal disease . There are a total of over 90 different types of the germ. It usually becomes dangerous when the body’s immune system weakens, for example in the case of influenza-like respiratory infections . Due to the widespread spread of the germs, the Standing Committee on Vaccination (STIKO) of the Robert Koch Institute recommends a pneumococcal vaccination in infancy.

What is the benefit of the pneumococcal vaccine?

In adults, pneumococci are the cause of severe respiratory infections in about one third of all cases. In children, they are the most common reason for bacterial inflammation of the middle ear, lungs or paranasal sinuses. In severe cases, meningitis can also occur. If the pneumococci spread through the bloodstream during or after an illness, this can also lead to blood poisoning.

People who have a weakened or immature immune system are particularly at risk of contracting pneumococci. These include in particular old people and small children, especially when they are already suffering from a viral infection. People with metabolic diseases such as diabetes mellitus, chronic diseases of the cardiovascular system, lungs or kidneys and people who have had their spleen removed also belong to a special risk group.

Since the pneumococcal pathogens are so widespread, it certainly makes sense for members of the groups mentioned to undergo the pneumococcal vaccination to protect themselves from the disease. Due to the liberal prescription of antibiotics even for minor infectious diseases, resistance has already developed in some strains of pneumococcus germs, which means that pneumococci can often no longer be treated with antibiotics.

Vaccination critics complain that the pneumococcal vaccination does not offer sufficient protection, since in the best case it is not even directed against a third of all pneumococcal species and an illness is therefore not unlikely despite vaccination. The short duration of the vaccination protection, which should be renewed every few years in high-risk groups, speaks for the vaccination critics against a pneumococcal vaccination.

When is a pneumococcal vaccination useful?

The STIKO recommends the pneumococcus vaccination from the age of two months. Just like the six -fold vaccination, it is divided into four partial vaccinations, which should be completed by the end of the first year of life:

  • 1st vaccination: From the end of the 2nd month of life
  • 2nd vaccination: From the end of the 3rd month of life
  • 3rd vaccination: From the end of the 4th month of life
  • 4th vaccination: between 11 and 14 months of age

A booster of the pneumococcal vaccination is only recommended for young people if they are exposed to the ongoing risk of disease, for example because they belong to a special risk group. In such a case, the vaccination should be repeated every three to five years.

There should be at least 4 weeks between each vaccination. There should be an interval of six months between the third and the fourth partial vaccination. Since the recommended times for the vaccination correspond exactly to those of the six-fold vaccination, the STIKO advocates carrying out the immunizations at the same time.

The STIKO also recommends the pneumococcal vaccination for people over the age of 60. The vaccination protection should be checked again every six years and refreshed if necessary, since the antibodies in older people fall off more quickly than in young people.

Survey: frequency of pneumococcal vaccination

In our MomaSquad survey, we asked 550 mothers whether they had their child vaccinated against pneumococci according to the STIKO recommendations. 75 percent of mothers have their child vaccinated at the recommended time. 10 percent usually catch up in the following first year of life. 10 to 15 percent of mothers do without a pneumococcal vaccination in their child.

Source: MomaSquad survey of 550 mothers (2011)

How to vaccinate

There are two different vaccines available for pneumococcal vaccination. Both are inactivated vaccines, which means that they do not contain any active components of the pathogen, which is why the vaccine, unlike the serum against measles, mumps and rubella (MMR) , cannot trigger the disease.

For children from the age of three, as well as adolescents and adults, there is the so-called polysaccharide vaccine, which is intended to protect against the 23 most common pneumococcal pathogens. With this vaccine, only a single vaccination is necessary.

Since the immature immune system of infants and very young children cannot “recognize” the parts of the pneumococcal germ contained in the polysaccharide vaccine due to their nature, it cannot react to them sufficiently to produce sufficient antibodies and thus create immunization protection. For this age group there is therefore the so-called conjugate vaccine, in which the vaccine antigen is bound to a carrier protein that is also recognized by the child’s immune system and attacked sufficiently. Although the conjugate vaccine contains only 13 types of germs, these are the most common triggers of pneumococcal diseases in the first two years of life.

Who should not get the pneumococcal vaccine?

Even if vaccination against pneumococci generally makes sense to you, you should refrain from administering a vaccination under certain circumstances:

  • If the vaccinated person has an acute infection associated with fever, the pneumococcal vaccination should be postponed until a few weeks after recovery. A simple sniffle is not usually a reason to postpone or skip a vaccination.
  • If a very pronounced vaccination reaction has already occurred after a vaccination, the same serum should not be used again. Critical overreactions are, for example, high fever, fainting, seizures or shortness of breath.
  • If there is a known allergy to one of the ingredients in the vaccine, another vaccine should be used if possible.
  • Babies suffering from certain types of blood clotting disorders should only be vaccinated if the doctor treating them considers the benefit of the pneumococcal vaccination to be significantly higher than the potential risk.
  • If the vaccinated person has had a pneumococcal disease within the last six years before the new vaccination, no polysaccharide vaccine should be used, as severe physical reactions can occur due to antibodies remaining in the blood. The same applies if a repeat vaccination falls short of the intervals recommended by the STIKO.

It is important that you have a detailed consultation with the doctor treating you before an upcoming vaccination. In such a conversation, he can point out possible risks of the vaccination and, if necessary, recommend alternatives.

Possible side effects of the pneumococcal vaccination

As with many vaccinations, mild vaccination reactions can occur following immunization against pneumococci. These include, for example, redness, swelling and slight pain at the injection site. Temporary, palpable hardening of the surrounding tissue and swelling of the neighboring lymph nodes are also possible.

After the use of both pneumococcal vaccines, flu-like symptoms such as fever, muscle, headache and body aches or gastrointestinal complaints occur, although these side effects tend to occur more frequently with the conjugate vaccine. This often results in irritability and drowsiness.

In rare cases, temporary blood clotting disorders may occur. Shock-like states lasting several minutes after vaccination with the conjugate vaccine were also observed in infants and small children.

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