Doctors want pneumococcus vaccine added to immunization schedule

Streptococcus pneumoniae, also known as pneumococcus.
Streptococcus pneumoniae, also known as pneumococcus. Source:

In an appeal submitted to the Ministry of Social Affairs, the Estonian Ear, Nose and Throat and Head and Neck Surgeons Society is proposing that the Streptococcus pneumoniae (pneumococcus) be added to the national immunization schedule. S. pneumoniae is a bacteria that among other things causes acute otitis media (AOM), a type of ear infection, in small children.

Estonia is currently among the last countries in Europe where the pneumococcus vaccine is not already included on the national immunization schedule.

Society president Kristel Kalling told ERR that the addition of this vaccine to the immunization schedule would help prevent as well as reduce the burden of disease caused by the bacteria, noting that of bacterial illnesses, pneumococcus is the most common cause of AOM.

"Currently, our prevention opportunity lies in a vaccine that costs money, not a required vaccine, and this is likely the reason why illnesses caused by pneumococcus, including ear infections in our children, are still so common," she explained. "Something around nearly 90 percent of children under the age of five get it, and if we look by illness, the younger the child, the more often they have this type of ear infection."

Pneumococcus does respond to treatment with antibiotics, but in worst case scenarios, cases of AOM in children can have serious side effects, such as a ruptured eardrum, hearing loss or speech and development issues.

"The problem in turn is that if the disease moves beyond the ear, so to speak, it can cause inflammation of the tissue surrounding the ear, but also go much further into the brain, causing meningitis," Kalling said. "We may end up with bacteremia or sepsis."

In a written response to ERR, Eva Lehtla, adviser on media relations for health policy at the Ministry of Social Affairs, said that the need to publicly finance the pneumococcus vaccine has been a subject of discussion in the National Expert Committee on Immunoprophylaxis.

The committee has proposed prioritizing the vaccination of children in risk groups against pneumococcus. Committee member, family doctor and University of Tartu lecturer Marje Oona cited the same position, adding, however, that the vaccine would not protect against all strains of the pneumococcus bacteria.

"There are over 90 different strains of pneumococcus, and the vaccine does not protect against all of them," Oona said. "If we start administering this vaccine, we unfortunately cannot assume that the number of ear infections would be significantly reduced. It will certainly have some degree of effect, but the vaccine was actually developed first and foremost to defend against pneumococcal meningitis, and our goal here is mainly to protect children falling into the risk group."

The risk group includes children who were born prematurely and those with cochlear implants. According to Lehtla, the Estonian Health Insurance Fund (Haigekassa) is currently conducting a cost-benefit analysis of providing pneumococcal vaccines to risk groups; it will be discussed at a meeting of the expert committee to take place on Dec. 3.


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Editor: Aili Vahtla

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