Pneumococcal Polysaccharide Vaccine (PPV23)

Pneumo 23 or Pneumovax 23
Vaccines (or needles) are the best way to protect
against some very serious infections. The National
Advisory Committee on Immunization (NACI)
recommends PPV23 for adults and children aged two
years and older who are at higher risk of serious
pneumococcal infections.

What are pneumococcal infections?

One type of bacteria that can cause an infection is
called Streptococcus pneumoniae (or pneumococcus).
Four out of ten healthy people have pneumococcal
bacteria in their mouth, nose, and throat without
becoming ill.
When these bacteria enter the body, they can cause
pneumococcal pneumonia, which is an infection of the
lungs. The bacteria can attack the blood cells and
cause a serious disease called bacteraemia. They can
also infect the fluid lining around the brain and spinal
cord causing meningitis.

pneumococcal disease:
chronic heart, kidney, or lung disease (except
asthma)
no spleens or spleens that do not work properly
diseases that weaken the immune system
taking medications that suppress the immune system
sickle cell disease
HIV infection
liver cirrhosis
past organ transplant
cochlear implants (pre/post implant)
diabetes
chronic cerebrospinal fluid leak
alcoholism
smoking
attending day care outside the home.

Each year in Ontario, about 1,500 cases of serious

pneumococcal disease are confirmed by laboratory
tests, but the actual number of cases is probably about
twenty times higher. Between 5-10 % of people with
serious pneumococcal infections die. This percentage
is higher in the very young, the elderly, and in people
who have other medical conditions.

Can pneumococcal infections be treated?

These bacteria can also cause milder forms of

pneumonia, sinus infections and middle ear infections
(otitis media), particularly in children. Children who
have repeated middle ear infections may require
surgery. They may also have loss of hearing.

How effective is the PPV23 vaccine against

pneumococcal infections?

Are some people at more risk?

Serious pneumococcal disease is most common in
children under two years of age and in people 65 years
of age and older. People of any age with any of the
following issues are also at higher risk for serious

Antibiotics can be used for treatment. However, some

pneumococcal bacteria have become antibiotic
resistant and antibiotics no longer kill them.
Antibiotic resistance makes it very hard to treat some
pneumococcal infections.

There are two kinds of pneumococcal vaccine.

PPV23, or pneumococcal polysaccharide vaccine,
protects against 23 types of pneumococcus. These 23
types account for 90 percent of the cases of
pneumococcal disease. PPV23 protects about 60
percent of people against pneumococcal infection.
Vaccination also makes the disease milder for those
who may catch it. PPV23 can be given to people two
years of age and older.

The other vaccine, Prevnar, is part of the routine

immunization schedule for infants and small children.
Prevnar protects 97% of children in this age group
against seven types of pneumococcus.

Who should get pneumococcal

polysaccharide vaccine (PPV23)?
PPV23 should be given to:
anyone aged 65 years and older.
anyone aged two to 64 years with a risk factor for
serious pneumococcal disease (listed on the
previous page).

When should PPV23 be given?

The PPV23 vaccine should be given as soon as a
person is known to have a risk factor for serious
pneumococcal infection, or at age 65 years. PPV23 is
usually given once in a lifetime. Only a few people
will need a booster dose of PPV23. Your doctor will
advise you if you need another dose. The vaccine can
be given at the same time as other vaccines such as
influenza or meningococcal C, but in a different arm.

Is PPV23 safe?
The PPV23 vaccine has been used in Canada since
1983. Some people have minor side effects from the
vaccine, which usually last only a short time. Five out
of ten people will have some swelling and soreness in
the arm where the needle was given. Occasionally, a
slight fever may occur. Less than one in 100 people
will have more serious swelling and pain in the arm.

If I notice something unusual after the

vaccine is given, when should I see a
doctor?
Serious side effects or allergic reactions can occur
with any medication, including vaccines. See your
doctor or go to the emergency room right away if any
of the following symptoms develop within three days
of getting PPV23:

hives
swelling of the face or mouth
trouble breathing
high fever (over 400 C or 1040 F)

convulsions or seizures
very pale colour and serious drowsiness
other serious problems

Who should not get the vaccine?

The vaccine should not be given to:

children under two years of age.

anyone who has had an allergic reaction to a
previous pneumococcal vaccine
anyone who has an allergy to phenol (a
preservative in the vaccine)
anyone who has a high fever or serious infection
worse than a cold
anyone who has had pneumococcal conjugate
vaccine (Prevnar) in the last eight weeks.

Most people do not need to get a second immunization

with PPV23. This includes people who received the
pneumococcal vaccine used between 1978 and 1983.
If you think you have already been vaccinated for
pneumococcal disease, tell your health care provider.
Tell your health care provider about any allergies,
medications, illness, or any previous suspected
reactions to a vaccine. These may affect how the
vaccine works. If you are sick, ask about waiting until
you feel better before getting the vaccine.

Who should I talk to if I have more

questions?
If you have more questions, speak to your health care
provider or call the Health Department at the number
below.

Your record of protection

Your health care provider will update your personal
immunization record, or give you a new one. Keep it
in a safe place!
For more information please contact

Halton Region
905-825-6000
Toll free: 1-866-4HALTON (1-866-442-5866)
TTY 905-827-9833
www.halton.ca

June 2007