Pneumococcal polysaccharide vaccine

How it works

It stimulates a T-cell-independent B-cell antibody response against the included capsular polysaccharides, promoting opsonisation and clearance of pneumococci, though it does not generate robust immunological memory.

Prescribing in practice

• Because the polysaccharide response is T-cell independent, it is poorly immunogenic in young children, so a conjugate vaccine is used instead in that group per the UK immunisation schedule.
• Routine re-vaccination is generally not recommended for immunocompetent adults; repeat dosing is reserved for defined high-risk groups as set out in current immunisation guidance.
• Administer by intramuscular (or subcutaneous) injection, ideally given before planned splenectomy or immunosuppression where feasible.

Monitoring

No routine laboratory monitoring is required; observe briefly after administration for immediate hypersensitivity.

Counselling the patient

• Mild soreness, redness or a low-grade fever after the injection is common and short-lived.
• This vaccine reduces the risk of serious pneumococcal infection but does not prevent all chest infections.
• Keep a record of the date given, as the need for any further dose depends on your individual risk.

Evidence & guidelines

PPV23 is recommended in the UK immunisation programme (Green Book) for adults aged sixty-five and over and for clinical risk groups.