UK Government changes pneumo vaccine programme

One dose of the pneumococcal vaccine has been removed from the UK’s routine childhood immunisation schedule for babies born on or after 1^st January 2020, following recommendations from the government’s vaccine advisors, the Joint Committee on Vaccination and Immunisation (JCVI).

All infants born before and including 31 December 2019 will remain on the 2 + 1 schedule (two vaccines in infancy – at two and four months - with a booster at one year of age).

The change to the schedule will mean babies from this month on will no longer be given a dose of the vaccine 2 and 4 months with a booster at 12 months.  Instead, babies born from January onwards will be on a 1 + 1 schedule and will be given one dose of the vaccine at 12 weeks, with a booster at 12 months.

The pneumococcal vaccine (called PCV 13) protects against thirteen strains of pneumococcal bacteria - a leading cause of bacterial meningitis.

MRF has been reassured that protection against pneumococcal meningitis will be maintained with the new schedule and that public health experts will be continuing to monitor the number of cases closely.

The JCVI report that the pneumococcal vaccine has not only successfully reduced cases of disease due to the 13 strains covered by the vaccine, but that it has also dramatically reduced the circulation of these bacteria amongst the wider population. They believe this means the risk of exposure to the 13 strains of disease has reduced so much that removing one vaccine dose in infancy would not result in a significant increase in cases. 

Research from Public Health England published in 2019 studied the impact of pneumococcal conjugate vaccines on pneumococcal meningitis in England and Wales.  The research found that the childhood pneumococcal vaccination programme has led to a significant reduction in the incidence of invasive pneumococcal disease including meningitis across all age groups.  The researchers estimated that more than 700 cases of pneumococcal meningitis have been prevented during the first decade. However, cases of pneumococcal meningitis, septicaemia and pneumonia due to pneumococcal strains not covered by the vaccine have been rising and are now responsible for far more cases in the UK than strains covered by PCV13.

Now that the majority of invasive pneumococcal disease is not currently vaccine preventable, MRF considers that alongside maintaining this reduction in cases, wider coverage should be a key aim for the future to reduce cases of this deadly disease still further. Research to develop improved pneumococcal vaccines is vital.

Vinny Smith, Chief Executive of Meningitis Research Foundation, said, “We have been reassured that protection will be maintained under these changes, but if we do see more children contracting pneumococcal meningitis due to vaccine preventable strains after the vaccine schedule changes, this would be unacceptable.

“We are pleased that the number of cases are to be kept under regular review, but we would like clarity on when and how the dose of vaccine would be re-introduced if cases of this deadly disease increased.

“A reduced schedule will make it more important than ever that people take up vaccines available to them. It is vital that children are immunised with the booster dose at one year of age to stop wider transmission of the disease causing bacteria.”

MRF has also urged for the changes to be communicated widely to parents so they know doses have been reduced.

The government has now published the following information:

• https://www.gov.uk/government/publications/routine-childhood-immunisation-schedule
• https://www.gov.uk/government/collections/pneumococcal-vaccination-programme
• https://www.gov.uk/government/publications/pneumococcal-vaccination-for-infants-leaflets