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Two different vaccines are available to prevent diseases due to the bacterium Streptococcus pneumoniae, more familiarly known as "pneumococcus". A vaccine called the pneumococcal "polysaccharide" vaccine has been available for many years and is given to older adults and to those with certain medical risk factors. It is commonly referred to as the "pneumonia shot" or "PPSV".

More recently, an effective vaccine against pneumococcal disease in children has been developed and is part of the recommended childhood immunization schedule. It is called the "pneumococcal conjugate vaccine" or "PCV-7" (Prevnar).

The pneumonia vaccine is given to children or adults at high risk for pneumococcal disease, including pneumonia. Pneumococci live in the nose, sinuses, ears, and throat. Anyone can get pneumococcal disease, but most healthy people do not get severely ill or die from it.

The pneumonia vaccine protects against discomforts and serious, sometimes fatal, complications that can occur when the bacteria spread in the body, such as:

• ear infections, known as acute otitis media
• pneumonia
• bacteremia, a serious blood infection
• meningitis, an inflammation of the covering of the brain and spinal cord

PCV-7 is given to prevent meningitis, serious bloodstream infections, and pneumonia in infants and young children. After Hib vaccines were introduced in the 1980s, pneumococci became the most important cause of these infections. Now, because of widespread use of this effective vaccine, pneumococcal infections in infants have also become much less common.

Who is a candidate for the procedure?

The U.S. government recommends PPSV for:

• all people 65 years or older
• adults and children with chronic lung or heart problems, such as chronic obstructive pulmonary disease or COPD
• people treated in the last year for cystic fibrosis, kidney disease, anemia, severe asthma, or chronic metabolic illnesses, such as diabetes
• people who do not have a spleen or who have had it removed
• people with weak immune systems, such as those on chemotherapy or a persons who are HIV-positive
• residents of a skilled nursing facility or extended care facility
• members of populations with a higher incidence of pneumococcal disease, such as Alaskan natives and some Native American peoples

PCV-7 is recommended for all infants. Four doses are given in the first two years of life. This vaccine is also given to children 2-4 years of age who have certain medical risk factors.

How is the procedure performed?

A shot is given into the muscle of the upper thigh or arm. For PPSV, usually one shot is enough. Occasionally a second shot is recommended at a 6-year interval for adults with certain chronic conditions.

What happens right after the procedure?

There may be tenderness at the site of the shot. A bandage is usually applied to stop any bleeding.

What happens later at home?

These vaccines are very safe. Severe allergic reactions are very rare. It is important to seek emergency medical care immediately if a person:

• is having trouble breathing, or shortness of breath
• has hives
• has a rapid heartbeat, pale skin, or other signs of anaphylactic shock

What are the potential complications after the procedure?

Pneumococcal disease is far more likely than the vaccine to cause serious problems for people who are at high risk for it.

• Mild side effects may include redness, pain, and swelling at the site of the shot for 1 to 2 days.
• Rarely, fever, muscle pains, or another reaction at the site of the shot occur.
• Occasionally seizures can occur because of the fever.
• Very rarely, a severe allergic reaction or even death can occur.