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As pneumococcal vaccine is added to the child schedule, experts are asking how uptake will be encouraged ­ Emma Wilkinson and Cato Pedder report

Pneumococcal vaccine will be added to the childhood schedule after the Government's immunisation advisers finally approved its introduction.

The Joint Committee on Vaccination and Immunisation agreed 'in principle' that pneumococcal vaccination would be offered to all children after deciding there was 'no medical reason' not to proceed.

But the need to allay parental fears over the vaccine is set to delay its introduction. Immunisation experts warned parents might be reluctant to accept the vaccine because they knew little about pneumococcal disease and did not appreciate its severity.

Dr David Elliman, consultant paediatrician at Great

Ormond Street Hospital, said: 'There is no question that pneumococcal vaccine would be beneficial. But it won't be as easy as the introduction of meningitis C vaccine and there will be much more needed in the way of education.'

The Department of Health plans to consult with parents and health professionals and will begin negotiations with vaccine manufacturer Wyeth over an acceptable price.

The JCVI has yet to decide on the number of doses or the ages at which they will be given, partly because of nervousness over parental reaction.

Professor David Goldblatt, member of the JCVI and consultant in paediatric immunology at the Institute of Child Health, told Pulse the vaccine could be given at two, three and four months or in a two-dose schedule at two and four months. There would also almost certainly be a booster in the second year of life with either schedule,' he said.

Dr Richard Slack, clinical senior lecturer in infectious diseases at the University of Nottingham and author of a 20-year surveillance study into pneumococcal disease, welcomed the decision.

'We showed that pneumococcal disease is quite a burden in children and their carers,' he said. 'The other important finding is that in the US it's having an impact on other childhood respiratory infections such as otitis media.'

RCGP immunisation spok-esperson Dr George Kassianos said: 'We are delighted the JCVI is recommending pneumococcal immunisation for our children.'

The annual burden

of disease the

vaccine may prevent

·70 meningitis cases

·300 bacteraemias

·3,000 pneumonia admissions

·4,750 ear tube placements

·25,000 GP consultations for otitis media

Source: Professor Brent Taylor, JCVI

Options for pneumococcal vaccine schedule

Three doses given at

two, three and four months

Would fit into the current schedule but mean giving three injections in one sitting, which may concern some parents

Two doses given at two and four months

Trials of a two-dose schedule have shown it to be effective; the JCVI has suggested that two doses of pneumococcal vaccine could be given alongside meningitis C at separate visits but more clinical trials are needed

Booster

Infants given either schedule may benefit from a booster after the age of 12 months but the JCVI is also currently considering the need for Hib and Men C boosters and is awaiting further trial results

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