June 26, 2000
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ACIP vote regarding pneumococcal conjugate vaccine

On June 21, 2000, the CDC, Advisory Committee on Immunization Practices (ACIP) voted to recommend the pneumococcal conjugate vaccine for all children 23 months of age and younger, and for children 24 to 59 months of age who are at high risk of serious pneumococcal disease, which includes children with sickle cell disease, HIV infection, chronic illness or weakened immune systems.

The vaccine is highly effective in preventing invasive pneumococcal disease in young children. Pneumococcal infections cause approximately 700 cases of meningitis, 17,000 cases of bacteremia (blood stream infections) and 200 deaths each year in children under age 5 in the United States. Streptococcus pneumoniae is the most common cause of community-acquired pneumonia in young children. Meningitis is the most severe type of pneumococcal disease. Of children under 5 years old with pneumococcal meningitis, about 5% will die of their infection. Many children with pneumococcal pneumonia or blood stream infection will be hospitalized and about 1% of children with blood stream infections or pneumonia with a blood stream infection will die of their illness.

The committee voted that the vaccine be given to all infants at 2, 4, and 6 months of age, followed by a booster dose at 12-15 months of age. Children who are unvaccinated and are 7 to 11 months of age should be given a total of 3 doses and children who are unvaccinated and are 12 to 23 months of age should be given a total of 2 doses. Healthy children who are unvaccinated at 24 months of age or older only need one dose of the vaccine.

The ACIP also recommended that the vaccine should be considered for all children age 24 to 59 months, with priority given to children at moderate risk of invasive pneumococcal disease. This includes all children aged 24 to 35 months, children of American Indian, Alaskan Native or African American descent, and children who attend out-of-home group child care.

The vote will become a final recommendation when it is published in the Morbidity and Mortality Weekly Report (MMWR).

The committee also voted to include this vaccine in the Vaccines for Children program, which provides free vaccines to children who are enrolled in Medicaid, uninsured, or are American Indian or Alaska Native. Additionally, children with health insurance which does not cover immunization may receive VFC vaccines at a Federally Qualified Health Center or a Rural Health Clinic.

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