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Pneumococcal vaccine scheme under review

Department of Health specialists are to review the adult pneumococcal vaccine campaign amid concerns it is failing to have any impact on disease rates.

The review will analyse data from across the UK and could recommend scrapping the programme altogether.

The Government's Joint Committee on Vaccination and Immunisation found 'little evidence' of a reduction in rates of invasive pneumococcal disease after introduction of immunisation for the over-65s in England and Wales.

The findings come in contrast to the success of the childhood pneumococcal campaign launched last year, which the committee reported had already brought a significant reduction in disease rates in children aged under two years.

Dr Syed Ahmed, a member of the JCVI and a consultant in public health medicine for NHS Greater Glasgow and Clyde, said: 'The JVCI is going to set up a subgroup looking at the benefit or otherwise of the vaccination programme. They are going to be looking at the indirect effects on pneumococcal disease incidence in the over-65s.'

By March 2006, 64% of patients over 65 had been vaccinated against pneumococcal disease, but there are concerns that uptake rates among other at-risk groups are far lower. A study published in the Journal of Infection in May found only 8% of those with risk factors other than age had been vaccinated.

The review will also examine the suggestion that any decrease in incidence since the programme's introduction in April 2005 is likely to be attributable to a 'herd immunity' effect, following the introduction of childhood vaccination.

Dr Ahmed said he expected the child vaccination programme to have a strong effect on the incidence of pneumococcal disease in adults, after 35-40% falls in similar circumstances in the US.

Dr George Kassianos, immunisation spokesperson for the RCGP, said the causes of the programme's apparent failure so far were still uncertain. 'We cannot be sure, but we should take into consideration that the UK introduction of immunisation of the over-65s was introduced at different periods and different ages in the four UK countries. In addition, the achieved immunisation rate is not high in every area.'

Pneumococcal vaccination at a glance Pneumococcal vaccination at a glance

• Single dose of pneumococcal polysaccharide vaccine is recommended for those aged over 65
• By March 2006, 64% of patients over 65 had been vaccinated
• PPV also recommended for younger people in at-risk groups, including those with chronic respiratory disease, CHD, CKD and diabetes
• Study published in Journal of Infection found only 8% of at-risk groups were vaccinated
• JCVI concluded that there was 'little evidence of an impact of the programme on the incidence of invasive pneumococcal disease'

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