Table. Risk conditions for pneumococcal vaccination and eligibility for NIP funding
Children and adults with the risk conditions listed below are at increased risk of pneumococcal disease and are recommended by ATAGI to receive additional doses of pneumococcal vaccine.
Some of these additional doses are funded under the National Immunisation Program (NIP), as indicated in the table below, with the specific pneumococcal vaccines recommended varying by age.
Recommendations for pneumococcal vaccination for people with risk conditions are available here. See also Vaccination for people who are immunocompromised for recommendations for immunocompromised people including specific revaccination recommendations and see also Infographic. Pneumococcal vaccination recommendations for people who have previously received a pneumococcal vaccine.
| Risk category | Details or specific conditions | NIP funded |
|---|---|---|
| Previous episode of invasive pneumococcal disease | Any previous episode of invasive pneumococcal disease | Yes |
| Functional or anatomical asplenia | Sickle cell disease or other haemoglobinopathies | Yes |
| Congenital or acquired asplenia (for example, splenectomy) or hyposplenia | ||
| Immunocompromising conditions | Congenital or acquired immune deficiency, including symptomatic IgG subclass or isolated IgA deficiency | Yes |
| Haematological malignancies | ||
| Solid organ transplant | ||
| Haematopoietic stem cell transplant | ||
| HIV infection | ||
| Immunosuppressive therapy, where sufficient immune reconstitution for vaccine response is expected; this includes those with underlying conditions requiring but not yet receiving immunosuppressive therapy | No | |
| Non-haematological malignancies receiving chemotherapy or radiotherapy (currently or anticipated) | No | |
| Proven or presumptive cerebrospinal fluid (CSF) leak | Cochlear implants | Yes |
| Intracranial shunts | ||
| Chronic respiratory disease (individual conditions listed and those that are similar based on clinical judgement) | Suppurative lung disease, bronchiectasis and cystic fibrosis | Yes |
| Chronic lung disease in preterm infants | ||
| Chronic obstructive pulmonary disease (COPD) and chronic emphysema | No | |
| Severe asthma (defined as requiring frequent hospital visits or the use of multiple medications) | No | |
| Interstitial and fibrotic lung disease | No | |
| Chronic renal disease | Relapsing or persistent nephrotic syndrome | Yes |
| Chronic renal impairment – eGFR <30 mL/min (stage 4 or 5 disease) | Yes, if eGFR <15 mL/min only (including patients on dialysis), otherwise no. | |
| Cardiac disease (individual conditions listed and those that are similar based on clinical judgement) | Congenital heart disease | Yes, for children who are aged <5 years when they start their recommended schedule |
| Coronary artery disease | ||
| Heart failure | ||
| Children born less than 28 weeks gestation | Any person born less than 28 weeks gestation | Yes, for children who are aged <5 years when they start their recommended schedule |
| Trisomy 21 | Any person with trisomy 21 (Down syndrome) | Yes, for children who are aged <5 years when they start their recommended schedule |
| Chronic liver disease (individual conditions listed and those that are similar based on clinical judgment) | Chronic hepatitis | No |
| Cirrhosis | No | |
| Biliary atresia | No | |
| Diabetes mellitus | Any person with diabetes | No |
| Smoking | Current smoker or in the immediate past | No |
| Harmful use of alcohol | Consuming on average ≥60 g of alcohol (6 Australian standard drinks) per day for males and ≥40 g of alcohol (4 Australian standard drinks) per day for females | No |