For children ≤5 years of age, recommendations for pneumococcal vaccination are the same whether the child’s condition is in Category A (the highest risk) or Category B (an increased risk).
For children >5 years of age, adolescents and adults, recommendations for pneumococcal vaccination depend on whether the person’s condition is in Category A (the highest risk) or Category B (an increased risk).
See also Vaccination for people who are immunocompromised for more recommendations for people who are immunocompromised, including specific revaccination recommendations for haematopoietic stem cell transplant recipients.
Category A: Conditions associated with the highest increased risk of invasive pneumococcal disease
Functional or anatomical asplenia, including:
- sickle cell disease or other haemoglobinopathies
- congenital or acquired asplenia (for example, splenectomy), or splenic dysfunction
Immunocompromising conditions, including:
- congenital or acquired immune deficiency, including symptomatic IgG subclass or isolated IgA deficiency (note: children who need monthly immunoglobulin infusion are unlikely to benefit from vaccination)
- immunosuppressive therapy (including corticosteroid therapy ≥2 mg per kg per day of prednisolone or equivalent for more than 1 week) or radiation therapy, where there is sufficient immune reconstitution for vaccine response to be expected
- haematological and other malignancies
- solid organ transplant
- haematopoietic stem cell transplant
- HIV infection (including AIDS)
- chronic renal failure, or relapsing or persistent nephrotic syndrome
Proven or presumptive cerebrospinal fluid leak
- Cochlear implants
- Intracranial shunts
Category B: Conditions associated with an increased risk of invasive pneumococcal disease
Chronic cardiac disease:
- particularly cyanotic heart disease or cardiac failure in children
- excluding hypertension only (in adults)
Chronic lung disease, including:
- chronic lung disease in preterm infants
- cystic fibrosis
- severe asthma in adults (requiring frequent medical consultations or the use of multiple medications)
Chronic liver disease
Preterm birth at <28 weeks gestation
Tobacco smoking (not a medical condition, but associated with an increased risk of pneumococcal disease)
History of previous invasive pneumococcal disease in children.
- acquired immunodeficiency syndrome
Printed content may be out of date. For up to date information, always refer to the digital version: https://immunisationhandbook.health.gov.au/resources/handbook-tables/list-conditions-associated-with-an-increased-risk-of-invasive-pneumococcal.