Who Should Get a Pneumococcal Vaccine in the Philippines?

In 2018, pneumonia caused approximately 56,800 deaths, making it one of the leading causes of deaths in the country¹. However, despite the staggering number of cases, common types of pneumonia are easily preventable through vaccination. Thankfully, there are several types of pneumococcal vaccine in the Philippines available from your doctor or local health center.

The Types of Pneumococcal Vaccines Available in the Philippines

Currently, there are three types of pneumococcal vaccine in the Philippines. Three of these are pneumococcal conjugate vaccines, PCV7, PCV10 and PCV13. Another type is the pneumococcal polysaccharide vaccine, PPSV23. The differences between each vaccine is outlined below.

Pneumococcal 7-Valent Conjugate Vaccine (PCV7)^{2, 9}

This was the first pneumococcal conjugate vaccine licensed for use. Pneumococcal conjugate vaccines combine sugar components from the capsule of Streptococcus pneumoniae bacteria and the diphtheria CRM197 protein.

The PCV7 vaccine provides protection against these serotypes (or strains) of S. pneumoniae: 4, 6B, 9V, 14, 18C, 19F, and 23F. These serotypes commonly cause pneumococcal infections such as pneumonia and acute otitis media.

PCV7 is used only for pediatric patients. As of today, this vaccine has been enhanced to produce the PCV13 vaccine and provide expanded coverage against more serotypes.

Pneumococcal 10-Valent Conjugate Vaccine (PCV10)³

The PCV10 vaccine protects against 10 serotypes of S. pneumoniae that commonly cause infections such as pneumonia and otitis media. The serotypes that are covered include: 1, 4, 5, 6B, 7F, 9V, 14, 18C, 19F, and 23F.

PCV10 was one of the vaccines used by the Department of Health (DOH) as part of the Expanded Program on Immunization (EPI) for children⁴.

Pneumococcal 13-Valent Conjugate Vaccine (PCV13)⁵

The PCV13 vaccine offers protection against the same serotypes as PCV10 plus added coverage against S. pneumoniae serotypes 3, 6A, and 19A.

Currently, this vaccine is the most recommended to prevent pneumococcal infections in children, starting as early as 6 weeks of age⁴. It is also the vaccine given to adults with chronic diseases, compromised immunity, or are otherwise at-risk for pneumococcal infection.

As of 2014, the Department of Health (DOH) has shifted from providing PCV10 to PCV13, as it is more cost-effective and provides coverage against serotype 19A⁶.

Pneumococcal Polysaccharide Vaccine (PPSV23)⁷

The PPSV23 is another vaccine that offers protection against a variety of serotypes of S. pneumoniae. The serotypes it covers include: 1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F, and 33F.

The PPSV23 vaccine formulation is different from the PCV vaccines. It does not combine the bacterial capsule sugars with the diphtheria CRM197 protein. Without this protein carrier, there is no immune memory, unlike with the PCV vaccines⁸. Therefore, while PPSV23 provides coverage against more serotypes, it does not offer lifetime protection.

Who Is Eligible for a Pneumococcal Vaccine in the Philippines?

In an ideal world, everyone should be vaccinated against pneumococcal infections and other preventable diseases. As part of the childhood vaccination schedules, both local and international, PCV is highly recommended. In the Philippines, PCV13 is currently used for routine vaccination.

Children Under 2 Years

As part of routine vaccination, PCV13 is given in 4 doses. Children are eligible for the PCV vaccines starting at the age of 6 weeks, though generally the first dose is given at 2 months old. The following doses are given at 4 months, 6 months, and then at 12-15 months.

Children and Adults (6 to 64 years old)

For children and adults between 6 and 64 years old who have never received a PCV vaccine, one dose can be given. This group should receive the vaccine if they have cochlear implants, cerebrospinal fluid (CSF) leaks, asplenia, or compromised immunity⁹.

The PPSV23 vaccine can be given in addition to the PCV13 vaccine in adults and children over 2 years old. But it cannot be given to children under 2 years because they will not develop an effective immune response⁷.

The Elderly (65 years and older)

As of 2019, the Advisory Committee on Immunization Practices (ACIP) states that PCV13 can be given to adults 65 years and older who do not have immunocompromising conditions, CSF leaks, or cochlear implants¹⁰.

In this updated guideline, all adults over 65 years old should get one dose of PPSV23, regardless of the previously mentioned conditions. If PCV13 is given first, they should wait at least 1 year before receiving PPSV23.

For more information on the available pneumococcal vaccines and how they are given to eligible patients, talk to your doctor.

Learn more about pneumonia here.