Pneumococcal disease
What is pneumococcal disease
Pneumococcal disease is caused by a type of bacteria called Streptococcus pneumoniae, which can infect the nose, throat, and lungs. It can also be a complication of the flu. Pneumonia and symptoms can be mild to severe. This infection can lead to pneumonia (lung infection) or in more severe cases, bacteremia (bloodstream infection) and meningitis (brain infection). Pneumonia is a leading cause of hospitalization in both children and adults.
There are two main types of pneumococcal disease.
Non-invasive pneumococcal disease (NIPD) which can cause infections in the ears, sinuses, or lungs.
Invasive pneumococcal disease (IPD) which is a lot more serious can lead to pneumonia, bacteremia, sepsis, meningitis, death, or long-term complications. IPD is most common in young children, the elderly and persons at increased risk due to underlying medical, environmental or living conditions.
Symptoms of Pneumococcal Disease
- General Symptoms: Fever, irritability, and loss of appetite
- Meningitis or Bacteremia: Headache, vomiting, stiff neck
- Pneumonia: Coughing with thick mucus, breathing difficulties
- Ear Infection (Otitis Media): Severe ear pain
Who is at risk for Pneumococcal disease?
Infections caused by Streptococcus pneumoniae are a major cause of illness and death worldwide. Pneumonia is the most common cause of pneumococcal-attributed death. The World Health Organization estimates that worldwide, almost 500,000 deaths among children aged less than 5 years are caused by pneumococcal disease each year.
While anyone can get pneumococcal disease, certain groups are at higher risk:
- Infants and young children: especially those with asthma, diabetes, or other chronic conditions like heart disease, HIV, or immune deficiencies. Children with cochlear implants, weak spleens, or on immunosuppressive therapy are also at higher risk.
- Adults with health conditions: people with asthma, HIV, diabetes, or heart disease, and those over age 65 are more vulnerable.
- Environmental or lifestyle factors: smoking, homelessness, living in long-term care, and alcohol use can also increase risk.
Current evidence indicates that asthma is a risk factor for serious pneumococcal disease, even in the absence of prolonged systemic corticosteroid use or COPD.
Why get vaccinated for pneumococcal disease?
Pneumococcal vaccination is part of routine immunization schedules in Canada for infants, children, adults and high-risk groups. Pneumococcal vaccines can protect against 24 of the 92 known strains of streptococcus pneumoniae that can cause invasive disease. There are different pneumococcal vaccines available and recommended in Canada. Pneumococcal infection can cause severe disease in people living with asthma and the most effective way to prevent these infections is through immunization.
How do pneumococcal vaccines work?
The pneumococcal vaccine stimulates an immune response that fights of the bacteria by producing antibodies (proteins that help fight the infection) against severe disease if exposed to pneumococcal bacteria.
Types of pneumococcal vaccines available in Canada
There are two main types of vaccine to prevent IPD: conjugate pneumococcal vaccines and pneumococcal polysaccharide vaccines.
Pneumococcal conjugate vaccines
- SYNFLORIX® (pneumococcal 10-valent conjugate vaccine) (Pneu-C-10)
- Prevnar®13 (pneumococcal 13-valent conjugate vaccine) (Pneu-C-13)
- VAXNEUVANCE® (pneumococcal 15-valent conjugate vaccine) (Pneu-C-15)
- PREVNAR 20™ (Pneumococcal 20-valent conjugate vaccine) (Pneu-C-20)
- CAPVAXIVE™ (Pneumococcal 21-valent conjugate vaccine) (Pneu-C-21) (This vaccine is being reviewed by the NACI for use in adults)
Conjugate vaccines are recommended for routine immunization of infants. The effectiveness of Pneu-C-13 in children less than 5 years of age is 20% and 77% against pneumonia and 67% to 96% against invasive pneumococcal disease.
Pneumococcal polysaccharide vaccine
- PNEUMOVAX®23 (pneumococcal polysaccharide 23-valent vaccine) (Pneu-P-23)
The polysaccharide vaccine is recommended for those over the age of two years who are at high risk of IPD and among healthy young adults. The efficacy of Pneu-P-23 vaccine is more than 80% against invasive pneumococcal disease among health young adults and 50% to 80% in older adults and high-risk groups.
Useful Resources:
Asthma and Vaccines
People with asthma face a higher risk of serious illness from preventable diseases, making vaccination extremely important.
Lung Vaccination Working Group
Within Canada, vaccine uptake continues to be a significant area of concern.
Controlling Asthma
When asthma is unmanaged, it can put a pause on your life. Learn how to break breathlessness and press play on life.
Asthma Canada's FREE Asthma & Allergy HelpLine
If you have questions on vaccines and asthma, please contact our free HelpLine at 1-866-787-4050 or info@asthma.ca. Our team of asthma and allergy experts will happily assist you with your asthma control and help put your mind at ease.
Jaqueline Murdoch: Asthma and Vaccine Champion
Jaqueline Murdoch, 75, a retired IT manager and personal trainer, is a passionate advocate for vaccination, shaped by a lifetime of health challenges and early experiences with preventable diseases. Diagnosed with asthma in 2012, she manages her condition with a rigorous health routine and proactive vaccination. Jaqueline received all available COVID-19 doses, annual flu shots, and vaccines for shingles and pneumonia, seeing immunization as essential to reducing severe illness. Having witnessed the impact of diseases like polio and shingles, she urges others to “look at the science” and stay informed, firmly believing that vaccines are key to a long, healthy life.
Frequently Asked Questions about Pneumococcal Vaccines
Who is the pneumococcal vaccine for?
Adults at risk of pneumococcal disease infection include those with chronic underlying conditions like asthma. If you have asthma, pneumococcal vaccination is recommended for you.
Pneumococcal vaccination is also recommended for children with asthma. Pneumocccal vaccination is a part of routine immunizations of infants and children.
In Canada, pneumococcal vaccine is recommended for:
- routine immunization of infants and children
- immunization of children who missed pneumococcal immunization on the routine schedule
- immunization of people at high risk of pneumococal disease due to underlying medical conditions. High risk conditions include chronic lung disease, including asthma requiring medical care in the preceding 12 months
- immunization of residents of long-term care facilities
- immunization of adults who are at high risk of IPD due to lifestyle factors: smokers, persons with alcoholism, persons who are homeless
- immunization of all adults 65 years of age and older
What are the benefits of getting vaccinated?
Getting a pneumococcal vaccine is the best way to avoid getting pneumococcal disease. If you do get pneumococcal disease, pneumococcal vaccines reduce the risk of serious complications.
Why is it so important for people with asthma to get the pneumococcal vaccine?
For people with asthma, pneumococcal disease can be especially serious. Research is still ongoing as to why they are more at risk.
If you live with asthma, it’s important to speak with your healthcare provider about getting immunized, because vaccination is the most effective prevention against pneumococcal disease.
Why is it so important for people with asthma aged 65 and older to get a pneumococcal vaccine?
As we get older, our immune system can get weaker. This puts us at greater risk for certain diseases. Vaccine-preventable diseases like pneumococcal disease are more common with age.
If you’re over 65 years of age and living with asthma, it’s even more important to be immunized against pneumococcal disease. The National Advisory Committee on Immunization (NACI) recommends that for older adults, the pneumococcal vaccine should be offered in routine immunization programs for all adults aged 65 years and older for the prevention of invasive pneumococcal disease.
Do I have to get the pneumococcal vaccine every year like the flu?
No. The pneumococcal vaccine is not an annual vaccine. Speak to your health care provider about your vaccination schedule for pneumococcal disease.
Pro tip: Your risk of pneumococcal infection increases if you get the flu. It’s a good idea to get BOTH your flu shot and the pneumococcal vaccine.
What pneumococcal vaccines are used to prevent pneumococcal disease?
For children:
Pneu-C-10: Conjugate 10-valent pneumococcal vaccine
Pneu-C-13: Conjugate 13-valent pneumococcal vaccine
For adults:
Pneu-C-13: Conjugate 13-valent pneumococcal vaccine
Pneu-P-23: Pneumococcal 23-valent polysaccharide vaccines
Is the pneumococcal vaccine safe?
Yes. Pneumococcal vaccines are safe and effective. Canadian laws and regulations set high standards for vaccine, development, safety, and testing. Canada also has strong health systems to oversee and monitor vaccines as they arrive on the market and are available to the public.
How do I get a pneumococcal vaccine?
Pneumococcal vaccination is part of routine immunization schedules in Canada. There are different vaccines available and recommended, so ask your healthcare provider about the immunization schedule in your province or territory.
Reference Guides for Health Care Providers