Pneumococcal immunisation schedule change comes into effect

For babies born from 1 January 2020, the vaccination schedule for the pneumococcal conjugate vaccine (PCV) has changed.

The routine infant PCV programme was introduced in the UK in 2006 using a 7-valent vaccine, which was replaced with the 13-valent vaccine in 2010.  | SCIENCE PHOTO LIBRARY
The routine infant PCV programme was introduced in the UK in 2006 using a 7-valent vaccine, which was replaced with the 13-valent vaccine in 2010. | SCIENCE PHOTO LIBRARY

Infants will now follow a 1+1 PCV schedule, with a single priming dose of PCV offered with the other routine infant vaccinations at 12 weeks of age and a booster dose at one year of age (on or after the first birthday).

This schedule change means that instead of three injections at the 8 and 16 week appointments (and one at 12 weeks), babies will only receive two injections at each of these appointments, plus oral rotavirus at 8 and 12 weeks.

Babies born on or after 1 January 2020 therefore no longer require an 8 week PCV dose. The first PCV vaccines to be given on the new 1+1 schedule will start in late March 2020 when these infants are 12 weeks of age.

Infants born on and before 31 December 2019 will remain on the previous 2+1 schedule, with doses at 8 and 16 weeks followed by a booster dose at one year old.

Successful programme

Public Health England says the change to the schedule is being made because of the success of the pneumococcal vaccine programme, which was introduced in 2006. High uptake of the 'very effective' conjugate vaccine has resulted in 'excellent control of the types of pneumococcal bacteria that the vaccine protects against', says PHE.

As very little disease caused by these bacteria is now seen in the UK, the Joint Committee on Vaccination and Immunisation has advised that a single dose of vaccine in infancy and a booster dose on or after the first birthday should continue to provide good protection for children and the community as a whole.

The 12-week dose offers infants some protection against pneumococcal infection caused by the vaccine serotypes and will also prime their immune system to respond to the booster dose at one year of age.

The booster dose not only provides direct protection, but also prevents the vaccinated child from carrying pneumococcal bacteria in their nasopharynx and passing them on to others. This interruption of transmission is considered vital to sustaining the high levels of herd protection for unvaccinated susceptible individuals achieved to date.

The change in the schedule is supported by several studies, including a clinical trial comparing the immunogenicity of the 2+1 and 1+1 schedules

PHE says the move to a 1+1 schedule reduces the number of vaccines administered at immunisation appointments and provides space in the vaccine schedule should any new vaccines need to be introduced in the future.

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