The Joint Committee on Vaccination and Immunisation (JCVI) has issued advice (PDF) that the routine pneumococcal vaccination programme for adults aged 65 years and older should be discontinued. This advice has also been the subject of a letter from the Department of Health that aims to provide information to help clinicians answer questions from patients.
The 23 valent pneumococcal polysaccharide vaccine was introduced in 2003 with the aim of reducing the incidence of invasive pneumococcal disease in the population aged 65 years and older. At the time it was noted that the effectiveness and duration of cover was uncertain.
A recent review has found no discernable decrease in the incidence of invasive pneumococcal disease in those aged 65 years and older following the introduction of the vaccination programme despite widespread use in this age group. It is additionally noted that since the introduction of a different pneumococcal vaccine into the childhood immunisation programme in 2006 there has been a decline.
JCVI have therefore recommended that the routine pneumococcal vaccination programme for those aged 65 years and older be discontinued but the vaccine should still be offered to those in clinical risk groups as the evidence on efficacy in younger people is more robust.
The Department of Health are seeking the views of professional and patient groups and the vaccine manufacturers before making a final decision.
Action: Clinicians should be aware of this advice and the Department of Health review. In the meantime, clinicians should continue to follow the existing guidance in the Green Book.