Pneumococcal infection

Invasive pneumococcal infection is a major cause of mortality in the UK. Pneumococcal pneumonia is estimated to affect one in every 1,000 adults each year, with 10 to 20 per cent of patients dying of the disease.13 Protection against this serious infection through vaccination is 60 to 70 per cent effective in the groups for which it is recommended.

Despite recent changes in vaccination policy in the UK which recommend the use of pneumococcal polysaccharide vaccine in certain at-risk groups, uptake of the vaccine remains low in those at risk (patients with chronic kidney, heart, liver or lung disease, immunosuppression due to disease or treatment, severe dysfunction of the spleen, or diabetes). There are, however, pockets of high uptake where local public health officials have realised the benefits of the vaccine and have actively encouraged its use.

With increasing competition for limited NHS funds, there are often arguments on the cost-effectiveness of vaccination. This may be a reason why pneumococcal polysaccharide vaccine has not been more widely used, despite being available for more than 20 years. Data from a recent European study confirm that pneumococcal vaccination is cost-effective. Its authors urged public health authorities to consider policies to encourage everyone aged 65 and over to be vaccinated.14

Flu vaccine

Even in winters when the incidence of flu is low, 3,000 to 4,000 deaths in the UK may be attributed to flu, mainly in the elderly.15 Current flu vaccines give up to 80 per cent protection. Annual protection with a vaccine containing the strains identified by the WHO as those most likely to cause infection in the next flu season has been shown to reduce the incidence of bronchopneumonia, hospital admissions and mortality in those most at risk of serious complications should they catch flu. The Department of Health in the UK changed to the recommendations for the use of flu vaccine in 2000, extending its use to include all those aged 65 and over.