Role of general practice
The infant pneumococcal vaccination program in Australia has an average coverage of 93%, but uptake of 23vPPV remains suboptimal, at 54% national coverage in 2009 and less than 50% in 2015-16 based on a NSW Health survey.14 Serotype replacement is occurring, with an increase in non-vaccine-type pneumococcal disease in Australia. Nevertheless, more effective prevention is possible if coverage rates are increased.
Despite the availability and use of 23vPPV in older people, making an impact on pneumococcal disease rates has been challenging. This is largely because of inadequate coverage, suboptimal effectiveness of this vaccine, serotype replacement and pneumococcal disease due to serotypes not covered in vaccines. In line with many other countries, Australia is reviewing its vaccine policy in older people now that 13vPCV has been licensed in this group. When patients request 13vPCV as well as 23vPPV, or their healthcare provider deems this desirable, then 13vPCV should either be given first or delayed for 12 months if 23vPPV has already been received. MT
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COMPETING INTERESTS: Professor Van Buynder has received support for research, education and marketing, travel and/or advisory board activities from Seqirus and Pfizer, manufacturers of pneumococcal vaccines.