Description

The goal of the pneumococcal vaccination program is to reduce the annual number of pneumococcal infections.

The vaccination program for adults includes one dose of pneumococcal polysaccharide vaccine at age 65. Individuals aged 2 to 64 years at greater risk of serious pneumococcal infection should also get the vaccine.

The vaccination program for children includes three doses of pneumococcal conjugate vaccine, administered at 2, 4 and 12 months of age. Two conjugate vaccines are available in Canada:

  • Synflorix®, which protects against 10 types of pneumococcus;
  • Prevnar 13®, which protects against 13 types of pneumococcus.

The vaccination schedule calls for one dose of Synflorix® at 2 and 4 months, followed by a dose Prevnar 13® at 12 months of age.

History of the vaccination program for children

From 2011 to 2018, Prevnar 13® was the vaccine used to vaccinate children as part of the Québec Immunization Program. Following the recommendations of an expert committee, in May 2018, Prevnar 13® was replaced by the Synflorix® vaccine. A number of countries, including the Netherlands, Finland, Sweden and Iceland use Synflorix® in their child immunization programs.

Since the introduction of the pneumococcal immunization program for children in 2004, previously common strains of the bacteria are now rarer in children. Over the past few years, countries using Synflorix® have seen a resurgence of a strain of the bacteria against which the vaccine provides no protection. Based on these findings, in September 2020, changes were made to Québec’s vaccination program for children.

Changes made to the vaccination program for children

Based on the types of pneumococcal bacteria currently circulating in Québec and which cause serious infections, an expert committee recommends using a mixed schedule for young children. Therefore, since September 1, 2020, the vaccination schedule for children has included two doses of Synflorix® and one dose of Prevnar 13®.

Experts consider that this schedule is just as effective as three doses of Synflorix® or three doses of Prevnar 13®. The three doses produce a very strong immune response to the 13 most common types of pneumococcus. In addition, by decreasing the number of doses of Prevnar 13®, this new schedule helps reduce local reactions caused by Prevnar 13® (heat, pain or swelling at injection site), which occur more frequently than with Synflorix®.

Québec is the only place where both vaccines are used to vaccinate children against pneumococcal infections. Québec had also the only place where, based on serious studies, two doses of human papillomavirus vaccine were given instead of three when HPV immunization was introduced in 2008. Now, most countries do the same as Québec.

To find out more about the vaccines used and the benefits of immunization, go to Pneumococcal Polysaccharide Vaccine and Pneumococcal Conjugate Vaccines.

Eligibility

Children

Pneumococcal vaccination is free for:

  • children aged 2 to 59 months;
  • children aged 5 to 17 years with one of the following conditions or illnesses:
    • heart disease;
    • lung disease (e.g., emphysema, chronic bronchitis);
    • asthma requiring regular medical follow-up;
    • kidney disease;
    • diabetes;
    • no spleen or a malfunctioning spleen;
    • liver disease (e.g., hepatitis);
    • weak immune system (e.g., due to cancer).

Adults

The following individuals can get the polysaccharide vaccine for free:

  • people aged 65 or over;
  • people with one of the following conditions or illnesses:
    • heart disease;
    • lung disease (e.g., emphysema, chronic bronchitis);
    • asthma requiring regular medical follow-up (only people aged 50 and over);
    • kidney disease;
    • diabetes;
    • no spleen or a malfunctioning spleen;
    • liver disease (e.g., hepatitis, cirrhosis, alcoholism);
    • weak immune system (e.g., due to cancer, HIV infection).

The following individuals can also get the Prevnar 13® polysaccharide vaccine for free:

  • people with no spleen or a malfunctioning spleen;
  • people with weak immune systems (e.g., due to cancer, HIV infection).

Cost

Pneumococcal vaccination is free for people who are eligible.

The vaccination schedule for children includes one dose of Synflorix® at 2 and another at 4 months of age, followed by a dose of Prevnar 13® at 12 months of age. It is possible to get three doses of Synflorix® or Prevnar 13® by contacting the CLSC or a doctor. However, doses not included in the vaccination schedule are not free.

The pneumococcal vaccination program offers no possibility of reimbursement. This means that if a person who is admissible to the program pays to get the vaccine in a pharmacy or travel clinic, the program will not reimburse the cost of the vaccine.

Other people have to pay for the vaccine. Since fees can vary, you can contact the vaccination site of your choice (CLSC, clinic or pharmacy) to find out the cost.

Procedure

The procedure to follow to get vaccinated varies by region.

To find out how to proceed and where to get vaccinated, contact your CLSC, doctor or pharmacist. For their contact information, see the section Finding a resource. You can also call Info-Santé 811 to find the vaccination location nearest you.