Summary

• Pneumococcal disease primarily affects the elderly with the average median age between 2014 and 2018 for deaths from pneumococcal being 64.5.  
• In the 9 years between 1990 and 1999 before the vaccine was introduced, there was a total of 3 deaths in under 5s in Ireland. 
• Pneumococcal disease is typically a benign illness in children that can be overcome with natural defences.  

Health Freedom Ireland (HFI) encourages you to become fully informed about vaccines and the associated illnesses so that you can give informed consent if you choose to vaccinate yourself or your child(ren). This information is for educational purposes only and is not intended as medical advice. HFI is simply bringing this information to you – we neither recommend nor advise against vaccination.

Does the HSE recommend a vaccine for pneumococcal disease?

The pneumococcal vaccine is recommended to children in Ireland as part of the Prevenar 13 vaccine at 2, 6 and 13 months of age.  See the Health Freedom Ireland article here on the Prevenar 13 (pneumococcal) vaccine – risks, benefits, ingredients and studies.

As of 23 September, 2023, there were 266,831 adverse events (including 2,150 deaths) reported on the World Health Organisation VigiAccess database for pneumococcal vaccines including Prevenar 13.

Does the pneumococcal vaccine guarantee protection?

As with all vaccines and as stated on the Prevenar 13 patient information leaflet, protection from the disease cannot be guaranteed.  Prevenar 13 will not protect against pneumococcal strains not included in the vaccine – there are 90 altogether. In 2016, the HPSC reported that 76% of infections were due to serotypes not covered by the vaccine.  

Bacterial meningitis caused by S. pneumoniae cases in Ireland
Year	2011	2012	2013	2014	2015	2016
Total Cases	23	37	32	39	29	37
Cases <9 years	n/a	n/a	7	6	5	5
At least one vaccination			6	3	3	3

What is pneumococcal disease?

Streptococcus pneumoniae (‘pneumococcus’) is the most common bacterial cause of pneumonia and one of the leading causes of meningitis in children. There are over 90 types of S. pneumoniae known (these are called serotypes). The vaccine used in Ireland – Prevnar 13 – aims to protect against 13 of these serotypes. Disease caused by any S. pneumoniae serotypes is called pneumococcal disease.

The organism is frequently found in the upper respiratory tract of healthy individuals worldwide. Between 20 and 60 percent of all school children may carry the bacteria.  Most pneumococcal infections run a benign course and can be treated with intravenous penicillin.

Symptoms of pneumococcal pneumonia, a lung infection, include fever and chills, cough, rapid breathing or difficulty breathing, chest pain.  The infection may start with a general feeling of being unwell, a low-grade fever and a cough that doesn’t include mucus before symptoms worsen. 

Otitis media, often referred to as a middle ear infection, is commonly caused by S. pneumoniae and remains the most common paediatric infection requiring treatment by the age of 12 months. Symptoms of otitis media include a painful ear, red or swollen eardrum, fever, and irritability. Over 60 percent of children will experience at least one ear infection before the age of one.

Children most at risk of developing invasive pneumococcal disease include those that are immunocompromised, those whose immune systems are weakened by malnourishment, those with symptomatic HIV infections and measles, those without a spleen or with cochlear implants. According to the WHO, the following environmental factors also increase a child’s susceptibility to pneumonia:

• indoor air pollution caused by cooking and heating with biomass fuels (such as wood or dung)
• living in crowded homes
• parental smoking.

The WHO also states that most healthy children can fight the infection with their natural defences.  Most paediatric cases of pneumococcal disease run a mild course and can be treated with intravenous penicillin.  

In the rare cases where it progresses to invasive pneumococcal disease, it can then cause meningitis (swelling in the brain) and septicaemia (blood poisoning) or both. At first, meningitis symptoms may appear mild and similar to cold or flu symptoms and may include headache, fever, aches, and pains. As the illness progresses, additional symptoms can include skin rash, severe headache, stiff neck, nausea, vomiting, inability to look at bright lights, mental confusion and irritability, extreme fatigue/sleepiness, convulsions, and unconsciousness. In babies, symptoms can include a high-pitched moaning cry, difficulty or refusal to feed, and the fontanel (the soft area on the top of the head) may be bulging. The HPSC advises seeking medical help immediately as the sooner treatment with antibiotics begins the greater the chance the person will make a full recovery.

What is the risk of my child getting pneumococcal disease in Ireland?

The risk for all age groups of getting pneumococcal disease in Ireland between the years 2014 and 2022 was extremely rare at less than 1 in 13,394 (0.007%).  The charts below highlight that pneumococcal disease is more prevalent amongst the elderly, in particular the over 85s.   

Pneumococcal cases in Ireland (PCV13 introduced 2010)
Year	2014	2015	2016	2017	2018	2019	2020	2021	2022
Cases	350	368	381	415	510	420	249	177	375
Median age	63	65.5	64	64	66	Not available	Not available	Not available	Not available
Cases < 2 years old	19	19	26	20	20	Not available	Not available	Not available	Not available
average population 2014 – 2022 =  4,829,094      average annual risk of getting pneumococcal disease during this period < 1 in 13,394 (0.007%) Average annual risk <2 years of age of getting pneumococcal disease during this period < 1 in 232,168 (0.0004%)

What is the risk of dying from pneumococcal disease in Ireland?

The risk for all age groups of dying from pneumococcal disease in the decade before the vaccine was introduced in 2000 was extremely rare at 1 in 20,000 (0.005%).  The risk of dying during this period for children under 5 was negligible at 1 in 12m (0.000008%).

Pneumococcal deaths in Ireland before the vaccine
	1990	1991	1992	1993	1994	1995	1996	1997	1998	1999
Total Deaths	211	197	203	204	203	221	227	207	183	222
Deaths < 5	0	0	1	0	0	0	0	1	1	0
Average population in Ireland from 1990 to 1999 = 3,608,300 Average annual risk of dying from pneumococcal disease during this period < 1 in 17,431 (0.006%)

Pneumococcal disease Vs vaccine risk summary

Read the Health Freedom Ireland article on the  Prevenar 13 (pneumococcal) vaccine for pneumococcal disease for further information including risk and ingredients analysis, studies in support of and studies highlighting concerns.

Further Reading

Join the parents support group to continue the discussion and learn from the experience of others

Health Freedom Ireland:

Health Freedom Ireland Prevenar 13 (pneumococcal) vaccine

Other:

• Health Service Executive (HSE) Pneumococcal disease
• National Immunisation Advisory Committee (NIAC) Pneumococcal infection
• Health Protection Surveillance Centre (HPSC) Pneumococcal disease
• World Health Organisation (WHO) Pneumococcal disease
• European Centre for Disease Prevention and Control (ECDC) Pneumococcal disease