Pneumococci are the key pathogens causing severe infections such as pneumonia, septicaemia and meningitis. These infections are commonest in elderly people and in children aged under five. Among elderly people, pneumonia is by far the most significant disease. In the Netherlands, about 10,000 patients a year get a severe pneumococcal infection and elderly people in particular have a high risk of this infection being fatal (10 to 15 per cent).
The Dutch Ministry of Health, Welfare and Sport has asked the Health Council of the Netherlands to provide recommendations about vaccinations against pneumococci in order to reduce the burden of pneumococcal disease among elderly people. To that end, the National Institute for Public Health and the Environment (RIVM) has collated the scientific information that is currently available about this disease. This includes the number of people who are made ill by pneumococci in the Netherlands and the effectiveness and safety of various pneumococcal vaccines in children and in elderly people. Two pneumococcal vaccines are licensed for use in elderly people, one vaccine that protects against thirteen types and one against 23 types.
Since 2006, the national immunisation programme (NIP) has vaccinated infants against pneumococcal disease. This vaccination was against seven types at first, and has been expanded to ten since 2011. These vaccinations have greatly reduced pneumococcal disease among children. Vaccinating children also has an effect on the extent to which various types of pneumococcus are found in elderly people. As a result, there has been a reduction in the number of elderly people who are falling ill from the types of pneumococcus that children are vaccinated against. There has, however, been an increase in the number of elderly people falling ill from types of pneumococcus that have not been included in the vaccine for children. Consequently, the number of sick elderly people is still high.