Pneumococcal Disease

Update: You can book a pneumococcal vaccination at a participating CHAS GP clinic here.

Pneumococcal Disease Causes and Risk Factors

Pneumococcal disease (PD) is caused by a bacterium called Streptococcus pneumoniae, which is also known as pneumococcus. There are more than 90 serotypes of this bacterium.

Pneumococcus can attack different parts of the body and cause serious infection of the following systems:

 • Lungs (pneumonia)

 • Blood (bacteraemia)

 • Coverings of the brain and spinal cord (meningitis)

 • Middle ear (acute otitis media)

It is common for people, especially children, to carry pneumococcus in their nose and throat. The bacteria can spread from person to person by:

 • Direct contact

 • Droplets from an infected person through coughing or sneezing

 • Articles contaminated with infected droplets

Not everyone exposed to the bacteria develops the disease. Some people become carriers, while others progress to develop the infection.

Although anyone can get pneumococcal disease, those at particularly high risk are infants and young children, adults who are 65 and older and individuals with chronic medical illnesses or weakened immune systems.

Related: Infectious Diseases

Pneumococcal Disease Signs and Symptoms 

Children under the age of 5 and adults aged 65 years and above, are among those who are at highest risk for pneumococcal disease. Within three days of becoming infected the following signs and symptoms may appear.

Symptoms can vary based on the systems affected.

• Bacteraemia — infection in the blood causing high fever and non-specific signs of illness
• Meningitis — infection around the brain causing fever, severe headache, vomiting, nausea, photophobia (avoidance of bright light owing to pain) and/or stiffness of the neck. Infants often have fever and non-specific signs of illness
• Pneumonia — infection in the lungs causing fever, chills, cough, chest pain and rapid breathing
• Acute otitis media — infection in the ear causing ear pain and fever
• Sinusitis — infection in the sinuses causing low-grade fever, runny nose and cough

Pneumococcal Disease Complications

 • Pneumococcal pneumonia may lead to a lung abscess and pericarditis (inflammation of the sac surrounding the heart).

 • Pneumococcal meningitis may cause significant learning disabilities, speech delays, paralysis and even death.

 • Recurrent otitis media can cause hearing impairment.

Pneumococcal Disease Diagnosis 

For non-invasive pneumococcal disease, such as pneumonia or otitis media, a physical examination and X-rays are required. Invasive pneumococcal disease is diagnosed by isolating the bacteria from the blood, spinal fluid, lungs or other body fluids.

Pneumococcal Disease Treatment 

Prompt treatment with antibiotics, such as penicillin, is usually effective. However, in recent years, treatment has become more challenging with the emergence of strains resistant to antibiotics, particularly penicillin. In this case, a longer hospital stay, together with expensive alternative therapy, may be needed.

Related: About Antibiotics

Pneumococcal Disease Vaccines

Vaccination

Vaccination is generally the safest and most effective way to protect young children, older adults and those with specific medical conditions against pneumococcal disease. There are several types of pneumococcal vaccines  described in the section below.

• Babies need a total of 3 doses of PCV13 during their first year of life.
  • At 4, 6 and 12 months of age. Children who fall behind should be given catch-up vaccination through to 59 months of age.
     
• For seniors 65 & above, 2 pneumococcal vaccination regimens provide life-long protection.
  • 1 dose of PCV20; or
  • 1 dose of PCV13 and/or 1 dose of PPSV23.
     
• People with specific medical concerns such as diabetes or chronic diseases of the heart, lungs, liver and kidneys as well as immunocompromised patients should talk to their doctor for vaccination advice specific to their age and medical condition.
   

PCV13 protects against 13 pneumococcal bacteria strains that most commonly cause pneumococcal disease, while the PPSV23 protects against 23 strains. PCV13 when given before PPSV23, provides extended protection in a selected group of patients, as compared to giving PPSV23 alone.

PCV20 provides coverage against 20 pneumococcal bacteria strains, including all 13 serotypes in PCV13, plus 7 additional serotypes. Under the National Adult Immunisation Schedule, only one dose of PCV20 is recommended regardless of age or conditions among the recommended groups.

Refer to the National Childhood Immunisation Schedule, National Adult Immunisation Schedule or ask your child’s doctor for more details. The vaccine may cause mild fever and some soreness around the site of injection, which usually lasts only a short time.

Related: What to Expect at a Vaccination Clinic 

Subsidised Pneumococcal Vaccinations

• For all eligible Singaporean children: Fully subsidised at CHAS GP clinics and polyclinics.
• For eligible Singaporean adults: Subsidies are available at CHAS GP clinics and polyclinics.
• For eligible Singaporean adults enrolled in Healthier SG: Special subsidies are available at their enrolled clinic.

MediSave can be used to offset the remaining cost of Pneumococcal Vaccinations for eligible Singaporeans (Citizens and Permanent Residents). Up to $500/$700 per year per account can be used to pay for pneumococcal vaccinations for those in high-risk groups as indicated above.

Read more on subsidies available, other vaccine-preventable diseases and frequently asked questions.

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