PNEUMOCOCCAL DISEASE

Updates & News

• 3rd Nov 2026: Pneumococcal green book chapter revised to to update the history and epidemiology of disease section, the dosage and schedule section, include Down syndrome as a specific clinical risk group, and update tables 3a and 3b for clarity, including vaccines for use.

• 31-valent pneumococcal vaccine passes Phase 3 trial: Vaxcyte’s experimental 31-valent pneumococcal conjugate vaccine, VAX-31, has produced encouraging Phase 3 results in adults aged 50 and over. The vaccine met non-inferiority criteria for the 28 serotypes it shares with existing higher-valency pneumococcal vaccines, while also generating strong responses to three additional serotypes unique to VAX-31. If successfully licensed, it could offer broader protection against invasive pneumococcal disease and pneumococcal pneumonia. Further Phase 3 results are expected in 2027, with a US licence application currently planned for 2028.

• Very pleased to see resources arriving in preparation for the new flu/pneumococcal eligible groups: Vaccination resources for people experiencing homelessness (PEH). These resources are to promote the availability of the flu and pneumococcal vaccines for those experiencing homelessness. And here is some useful guidance (and examples of good practice) Supporting vaccination of people experiencing homelessness: A multi-agency toolkit for planning and delivery of vaccinations to people experiencing homelessness. This was published in June 2026 and is also worth checking out: Understanding and addressing immunisation inequities toolkit.

• 25th Sept: Pneumococcal vaccination programmes for infants, adults and individuals at increased clinical risk: Added easy read guide to the pneumococcal vaccine leaflet.

• 8th September 2026: The Pneumococcal Info for HCPs guidance has now been updated to include people who experience homelessness (PEH) as a new risk group from 1st October 2026. They have also added further clarification of risk group information, and revised the text about use of PPV23 and PCV20 now that the latter is available to order. They also added a health equity statement and information.

• 5th August: Pneumococcal Green Book chapter updated following the MHRA approval of Capvaxive (PCV21) and JCVI advice on people experiencing homelessness.

• 3rd August 2026: Updated PCV20 PGD template to include the new homeless cohort. And also the PCV PGD amended to provide clarity for use of the vaccine, if required for a valid reason, from the age of 6 weeks up to 16 weeks in the action to be taken section.

• 14th July: Update to eligibility criteria!! Information on the inclusion of people experiencing homelessness (PEH) as a new clinical risk group eligible for pneumococcal vaccination from 1 October 2026.

• 1st May 2026: These two documents have been updated with data up to Dec 2025: Pneumococcal disease: cases caused by serotypes covered by Prevenar 13 vaccine and Pneumococcal disease: cases caused by serotypes not in Prevenar 13 vaccine. This UKHSA surveillance data demonstrates that the PCV13 programme has been highly successful in reducing invasive pneumococcal disease caused by vaccine serotypes. Since its introduction, cases of PCV13-type IPD have fallen dramatically across all age groups, particularly in children under 5 years, with additional herd protection seen in older adults through reduced transmission. Although the companion 'not covered by' report shows a rise in disease caused by non-PCV13 serotypes over time (serotype replacement), overall IPD rates remain substantially lower than before pneumococcal conjugate vaccines were introduced. Together, the reports highlight both the major public health success of PCV13 and the need for newer higher-valency vaccines to address changing serotype patterns.

• 13th April 2026: This document has had a tweak: Information for healthcare practitioners on delivering the pneumococcal vaccination programme for older adults and individuals in a clinical risk group. Updated with guidance on PCV13 given in error to those aged 2 years and above, and clarification of PCV21 antigen content (PCV21 contains 10 shared serotypes with PCV20 and 11 serotypes different to PCV20. All doses of PCV21 given at the correct ages and intervals are valid).

• 3rd Feb 2026: Calls for a national strategy for respiratory illness following rise in pneumonia cases

• 19th Jan 2026: Pneumococcal vaccination for older adults and for individuals in a clinical risk group: Information for healthcare practitioners published to aid with implementing the transition to PCV20. There is advice in there such as once available to order, even if PPV23 stocks haven’t finished, PCV20 should be used for those aged 2 years and above with severe immunosuppression. Additionally, health protection teams may access the national supply for management of outbreaks of pneumococcal disease in closed settings. However, in order to avoid wastage, PCV20 will not be available to order for other indications until the national stock of PPV23 has been exhausted. If PPV23 is indicated for an individual and is in the fridge, it must be used up first.

• 5th Jan 2026: PGD template updated to support the national pneumococcal vaccine (13-valent or 15-valent, adsorbed) (PCV) vaccination programme. Amended to

  • remove immunisation of individuals from 6 weeks of age in response to an outbreak of pneumococcal disease due to introduction of PCV20 for outbreaks

  • update 8-week dose interval to 4-week interval as per updated Green Book Chapter 25

  • inform to use PCV20 PGD for routine programme for individuals who have asplenia, splenic dysfunction, complement disorder or severe immunocompromise

  • delete off label use of dose schedules as SPC states that the schedules should be in accordance with national recommendations

  • add Prevenar 13® is interchangeable with other PCV vaccines as per the Green Book Chapter 25 in off-label section

  • add minimum 4-week dose interval in accordance with the Green Book, Chapter 25 where 8-week dose interval is indicated in the SPCs in off-label section

• 16th Dec 2025: Pneumococcal infant vaccination: information for healthcare practitioners updated to account for PCV14 and PCV20. See this letter (Change of vaccine for the routine adult pneumococcal vaccination programme and individuals at increased clinical risk) for implementation advice and further information. The letter and annex provide information on the change of vaccine for the routine pneumococcal vaccination programme for adults, for those aged two years and above in clinical risk groups for pneumococcal disease, and for children aged less than two years of age with asplenia, splenic dysfunction, complement disorder and severe immunosuppression. The following day the PCV20 PGD template came out.

• Private supply of Pneumovax 23 PFS is to be discontinued from October 2025

• 28th August 2025: Just published: Pneumococcal polysaccharide vaccine (PPV): coverage report, England, April 2024 to March 2025. Highlights: Coverage in those aged 65 and over was 73.6%. Worryingly, uptake was 15.4% in those aged 65. but did increase with age to 85.6% in those aged 75 and over. coverage in those aged 2 to 64 in one or more clinical risk group was 47.5%. Coverage in clinical risk groups ranged from 39.0% (chronic liver disease) to 70.0% (cochlear implants).

• 13th June 2025: An update to the Pneumococcal Green Book chapter. PCV 10 removed from the list (which was never used previously in the programme) and also check out this statement "PCV20 is expected to replace PPV23 in adults over 65 years and the at-risk programme in late 2025/early 2026"... watch this space I guess!

• 5th June 2025: PGD template update for PCV.

• 2nd June 2025: The Pneumococcal vaccination: information for healthcare practitioners guidance has also been updated and some slide sets have been removed relating to this programme. This is also useful as it focuses specifically on the changes to the pneumococcal programme: Changes to the infant pneumococcal conjugate vaccine schedule: information for healthcare practitioners

• 30th April 2025: A BIG update came along today - the 'changes to the routine childhood schedule letter'. Big read with lots of changes to absorb. I won't repeat it all here but do have a good read.... some of this relates to PCV13 scheduling on the childhood prog. (see UKHSA webinar link on news page in June and consider registering for more info). Expect Green Book updates, PGD changes and perhaps a small amount of chaos while we adapt to the changes. Keep calm and keep the kettle on....

• 31st March 2025: The annual reports from the national PPV immunisation programme are here. The main findings were that coverage in those aged 65 and over was 73.1%, an increase of 1.3 percentage points compared with the 2022/23 financial year. Coverage increased with age from 34.8% in those aged 65 to 85.3% in those aged 75 and over. Coverage in those aged 2 to 64 in one or more clinical risk group was 46.5%. Coverage in clinical risk groups ranged from 34.3% (chronic liver disease) to 84.2% (cochlear implants). See the report for more details.

29th Jan 2025: UKHSA PCV Risk Groups PGD amended to include:

• minor rewording, layout and formatting changes for clarity and consistency with other UKHSA PGD templates

• details of a newly approved PCV15-valent vaccine (Vaxneuvance)

• recommendation for PCV15 in addition to PCV13, in line with Chapter 25 updates in the Green Book

• updated considerations for individuals anticipated to receive a cochlear implant

• clarification of exclusion criteria for at-risk individuals aged 2 years and above

• clarification of the immunisation offer to at-risk individuals aged 10 years and over

• interval between PPV23 and PCV doses for at-risk patients clarified as 8 weeks, not 2 months, in line with Table 25.3 of the Green Book

• update of adverse reactions in common to both PCV vaccines

31st July 2024 PGD template updated amended to:

• confirm that PPV administration for occupational exposure should be under a Patient Specific Direction (PSD)

• include an updated list of known adverse reactions

• remove details of specific supply information for PPV (the supply route is now well embedded)

• reflect clinical exceptions to the recommended 8 week interval between PCV and PPV vaccination in special considerations and additional information section

Useful Resources

Go deeper here

• Lancet article leading to decision to move from 2+1 to 1+1 schedule

• JCVI minutes of interest

• Vaccinating Welders against pneumococcal - systematic review & meta analysis and further interesting analysis here

• Pneumococcal disease: cases caused by serotypes not covered by PCV13: This document contains 4 graphs showing cumulative weekly reports of invasive pneumococcal disease caused by serotypes not in PCV13. Data covers these age groups: aged under 2 years, aged 2 to 4 years, aged 5 to 64 years, aged 65 years or over

• Pneumococcal disease: cases caused by serotypes covered by PCV13: Cumulative weekly data on invasive pneumococcal disease infections due to serotypes in PCV13 in England.

• International study tests promising vaccine against 21 strains of pneumococcus.

• 5th March 2025: This is an interesting read BUT PLEASE NOTE IT IS AMERICAN and nothing has changed in the UK at the time of writing. New Pneumococcal Vaccine Recommendations: What You Should Know. I wonder if the UK will follow a similar process. Interesting the bits about blanket programmes having higher vaccine coverage than risk-based ones. It seems similar with our Shingles programme with the age-based programme doing better than the risk-based one.

• 11th Sept 25: Merck's pneumococcal shot shows promise in at-risk children and teens.

• June 2025: Pneumococcal vaccination for new residents entering older adult care homes in England: national observational surveillance study

Bits and bobs to casually drop into conversation

Did you know....

• Not just a 'pneumonia' vaccine!!! Pneumococcal disease encompasses a wide range of infections caused by different types of pneumococcus bacteria (Streptococcus pneumoniae). There are over 90 different types of them, and vaccines have been produced to protect against the types that cause the most disease

• The most common way to die of flu complications is pneumonia

• In the UK, around 40,000 people a year get hospitalised with pneumococcal pneumonia OF ALL AGES. Even with antibiotics, pneumonia still causes death in up to 20% of cases.

• Pneumonia is the leading cause of death in children worldwide. According to data from the WHO, pneumonia killed over 920,000 children in 2015, and accounts for 16% of all deaths of children under 5 years old.