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Pneumococcal Disease

Pneumococcal disease is most common in children under two years of age and in people over 65 years. Pneumococcal disease can sometimes develop into ‘invasive pneumococcal disease’ (IPD) which can cause serious diseases including meningitis (infection of the covering of the brain), septicaemia (blood infection), and pneumonia. NB: Pneumococcal disease is not meningococcal disease which is caused by another type of bacteria.

Signs and Symptoms: 

Symptoms can depend on where the infection is in the body. The bacteria can cause less serious infections such as middle ear infections and sinusitis. Symptoms of a more serious infection may include fever, chills, sweats, cough, shortness of breath, stiff neck and extreme tiredness. The person may become quite unwell, appearing either very quiet/inactive or continually distressed. Older children and adults may say they have a headache and bright lights hurt their eyes.


Appropriate antibiotic treatment is usually effective. However, pneumococcal bacteria are becoming increasingly resistant to some antibiotics.


Pneumococcal disease is caused by bacteria called Streptococcus pneumoniae (also known as the pneumococcus). There are different strains of the bacteria, some of which are more likely than others to cause disease. Many people carry pneumococcal bacteria in their nose and throat often without causing any health problems. The bacteria are easily spread from person to person by coughing or sneezing or contact with mucous from the nose and throat. Sometimes when people get the bacteria, they go on to develop pneumococcal disease.


Vaccination is the most effective way of preventing pneumococcal disease (see Immunisation). Reducing smoking can reduce the risk of infection. Adults should avoid smoking near other people especially young children and those who have other illnesses, such as chronic lung disease.


Vaccination against pneumococcal disease is recommended for both children and adults at risk of pneumococcal disease. Under the National Immunisation Program (NIP) funded vaccine is available for:

  • all infants aged 2, 4 and 6 months
  • children at high risk of serious disease including:
    • children under five years with underlying medical conditions predisposing them to higher rates and complications of pneumococcal disease (a fourth dose at 12 months and a booster dose at 4 years is recommended for this group)
    • Aboriginal and Torres Strait Islander children (a booster dose at 18 months is recommended for this group)

People eligible for funded Pneumovax 23® vaccine:

  • all adults from 65 years
  • Aboriginal and Torres Strait Islanders people aged 50 years of age
  • Aboriginal and Torres Strait Islander people aged 15 and 49 years with a medical risk condition
  • Children at four to five years of age with medical risk conditions.

Medical risk factors predisposing adolescents and adults to invasive pneumococcal diseases (IPD) are:

  • Medical risk conditions that predispose to IPD are:
    • Asplenia, either function (including sickle-cell disease) or anatomical: where possible, the vaccine should be given at least 14 days before splenectomy
    • Impaired immunity, including HIV infection before the development of AIDS, acute nephrotic syndrome, multiple myeloma, lymphoma, Hodgkin’s disease and organ transplantation
    • Chronic illness, including chronic cardiac, renal or pulmonary disease, diabetes, alcohol-related problems
    • CSF leak
  • Tobacco smokers.

The vaccine used for infant vaccination in the NIP is Prevenar 13® (the booster dose for medical at risk children at 4 years is Pneumovax 23®). The vaccine used for adolescents and adults is Pneumovax 23®.

Immunisation against pneumococcal disease is also recommended (but not funded) for:

  • children aged five to nine years who:
    • do not have a working spleen or have an underlying medical condition
    • have not received the full five doses of vaccine before their 5th birthday.
  • children aged nine years or younger diagnosed with an underlying medical condition since their 2, 4 and 6 month vaccinations.

For full protection against disease, it is important that all recommended doses of the vaccine are received at the recommended times. Talk to your doctor or immunisation provider.

Like all medications, vaccines may have side effects. Most side effects are minor, last a short time and do not lead to any long-term problems. Possible side effects of the pneumococcal vaccine may include swelling, redness and soreness where the injection was given and fever. More serious side effects are extremely rare. Paracetamol is recommended prior to vaccination for children who have seizure disorders or a previous history of febrile seizures. Talk to your doctor or immunisation provider for further advice. Contact your immunisation provider if you or your child has a reaction following vaccination which you consider serious or unexpected.

Health outcome: 

The course of disease depends on where the infection is in the body, the person's immune system, and the use of appropriate antibiotics. The illness may last anywhere from a few days to weeks. Pneumococcal pneumonia is fatal in about 5% of cases but the death rate is higher in people with underlying medical conditions (20% to 40%). Pneumococcal meningitis can cause death in 10% to 30% of cases, with most of these deaths occurring in the very young and the elderly.

Help and assistance: 

For more information about pneumococcal disease, contact your doctor or local public health unit. You can be immunised at your local doctor or medical centre. Check with your local council, community child health and community health centre regarding free immunisation clinics.

Other Resources

Heymann, D., Ed. 2008. Control of Communicable Diseases Manual, 19th edition. Washington, DC: American Public Health Association

Australian Government, 2012. The Australian Immunisation Handbook, 10th edition

If you are in a emergency situation, call 000


  • Get qualified health advice 24/7 for the cost of a local call. 13 HEALTH (13 43 25 84)
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Creative Commons Attribution 3.0 Australia (CC BY 3.0)
Last updated
25/07/2014 3:17:52 PM

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