Pneumococci/pneumonia-causing bacteria are common bacteria that cause respiratory infections such as sinusitis, ear infections, and pneumonia, but can in some cases, break through the respiratory tract and cause bloodstream infections, meningitis, bone and joint infections, and more. These are collectively referred to as invasive infections and can be life-threatening.
Vaccines have been developed against the types of pneumococci that are most likely to cause invasive disease.
Children in Iceland are vaccinated against pneumococci as part of the childhood immunization schedule, but vaccination may also be recommended for older individuals or with broader-coverage vaccines when specific risk factors are present.
The guidelines include, among other things, recommendations on vaccine selection when risk factors are present, as there have been significant changes in vaccine availability over the past two years.
Pneumococcal vaccination outside the national schedule is paid for by the individual receiving it.
The Chief Epidemiologist recommends the following use of pneumococcal vaccines:
PCV10 = Synflorix®
PCV13 = Prevenar 13®
PCV15 = Vaxneuvance®
PCV20 = Prevenar 20® (formerly Apexxnar®)
PCV21 = Capvaxive®
PPSV23 = Pneumovax®/Pneumo 23® and others.
Adults
- Automatic translation
Without risk factors:
Vaccination unnecessary
With risk factors: Patient pays for the vaccine
Immunocompromised:
Unvaccinated: At least one dose; physician may recommend additional doses if indicated
PCV20
PCV20 and PPSV23 also an option (0+6 schedule)
Previously vaccinated:
1+ doses of PCV10/PCV13/PCV15: PCV20 or PPSV23 recommended as an addition
PCV10/PCV13/PCV15 and PPSV23: PCV20 recommended as an addition
PPSV23 only: PCV20
PCV20 only: PPSV23 may be added
A 6-month interval between doses is preferred if more than one vaccine dose is given, minimum interval 2 months.
Other risk factors (not immunocompromised):
Unvaccinated:
One dose unless a physician recommends more
PCV20
PCV15 and PPSV23 also possible but more expensive
Previously vaccinated:
1+ doses of PCV10/PCV13/PCV15: PCV20 or PPSV23 possible as an addition
PCV10/PCV13/PCV15 and PPSV23: PCV20 possible as an addition
PPSV23 only: PCV20
PCV20 only: Vaccination considered complete for now (PPSV23 may be added at physician’s discretion)
A 6-month interval between doses is preferred if more than one vaccine dose is given, minimum interval 2 months.
- Automatic translation
Without additional risk factors:
Individual pays for the vaccine.
Unvaccinated:
PCV20 or PPSV23
Previously vaccinated:
PCV13/PCV15: PPSV23 (or PCV20) may be added
PCV10/PCV13/PCV15 and PPSV23: Vaccination considered complete (PCV20 may be added)
PPSV23 only: Vaccination considered complete (PCV15 or PCV20 may be added)
A 6-month interval between doses is preferred if more than one vaccine dose is administered; minimum interval is 2 months.
With risk factors:
Patient pays for the vaccine.
Immunocompromised
Unvaccinated:
At least one dose; physician may recommend more
PCV20
PCV15 and PPSV23 also possible but more expensive
Previously vaccinated:
PCV10/PCV13/PCV15: PCV20 recommended as an addition (PPSV23 may also be added at physician’s discretion)
PCV20: PPSV23 may be added at physician’s discretion
PCV10/PCV13/PCV15 and PPSV23: PCV20 recommended as an addition
PPSV23 only: PCV20
A 6-month interval between doses is preferred if more than one vaccine dose is administered; minimum interval is 2 months.
Other risk factors (not immunocompromised)
Unvaccinated:
One dose unless a physician recommends more
PCV20
PCV15 and PPSV23 also possible but more expensive
Previously vaccinated:
1+ doses of PCV10/PCV13/PCV15: PPSV23 or PCV20 recommended as an addition
PCV10/PCV13/PCV15 and PPSV23: PCV20 may be added
PCV20: Vaccination considered complete
PPSV23 only: PCV20
A 6-month interval between doses is preferred if more than one vaccine dose is administered; minimum interval is 2 months.
Children
PCV15 free of charge
Routine schedule: 3 doses at ages 3, 5, and 12 months
Not vaccinated according to the routine schedule — age at first dose:
Family pays for vaccines not included in the national schedule
Age 0–23 months:
Not previously vaccinated: 3 doses of PCV20 preferred, given at 0–2–6 months
Received 1–3 doses of PCV15: At least one dose of PCV20 recommended
Age 24 months–17 years:
Not previously vaccinated: At least one dose of PCV20 recommended
Received 1–3 doses of PCV10/PCV13/PCV15: At least one dose of PCV20 or PPSV23
The dosing schedule for vaccines given in multiple doses is written in the format:
“x + y” x refers to the number of doses in the primary series. y refers to the number of booster doses given after the primary series is completed.
¥ The timing of doses when multiple doses are given is written in the format:
“0–w–z” 0 refers to the day of the first vaccination. w refers to the minimum number of months (or other units) that must pass from “0” to the next dose. z refers to the minimum number of months/units that must pass from “w” to the next dose.
