According to statistics from the Hong Kong Department of Health, the incidence rate of pneumococcal disease in Hong Kong from 2009 to 2019 was between 1.7 and 2.9 cases per 100,000 people. Children under 5 years old and individuals aged 65 and above are considered high-risk groups. According to the data from the Centre for Health Protection, there have been 47 reported cases of invasive pneumococcal disease as of June 30th this year.

Don't mistake pneumococcus for a common cold. Dr. Hung Fan Ngai, a member of the Hong Kong Society for Infectious Diseases and a specialist in infectious diseases, pointed out that if infants or elderly individuals are infected by pneumococcus, it can lead to complications such as meningitis, with a mortality rate as high as 47%! Therefore, citizens should get vaccinated as soon as possible to protect the health of themselves and their families.

What is pneumococcus?

Pneumococcus (Streptococcus pneumoniae) is a common cause of pneumonia. It is primarily transmitted through droplets produced when patients cough or sneeze. During peak seasons of respiratory diseases such as the common cold and influenza, the number of pneumococcal infections also increases. To date, the medical community has identified over 90 different strains of pneumococcus. Among them, the most concerning is invasive pneumococcal infection, which can invade multiple organs and lead to pneumonia or various complications, including:

- Pneumonia

Symptoms include difficulty breathing, severe coughing, runny nose, nausea, vomiting, chills, and fever. It can easily lead to other complications.

- Otitis media

Symptoms include ear pain, ear discharge, hearing impairment, and potential hearing loss. It has a risk of spreading to the brain and causing meningitis.

- Meningitis

It could cause fever, stiff neck, coma, confusion, permanent intellectual damage, hearing loss, and even death.

- Bacteraemia and sepsis

Symptoms include joint pain, chills, rapid heartbeat, confusion, red patches on the skin, and shock. In severe cases, it can lead to organ failure, and the mortality rate of sepsis can reach 30%.

The government provides free vaccines but with limited protective coverage

Currently, the government offers free administration of 13-valent pneumococcal vaccine to children and the elderly. However, the protective coverage is not comprehensive. Dr. Hung Fan Ngai stated that the 13-valent vaccine has insufficient efficacy against serotype 3, which is a major cause of children being admitted to intensive care units.

According to data from the Department of Health, nearly 70% of paediatric cases of invasive pneumococcal disease are caused by serotype 3, and the number is continuously increasing. Approximately 50% of adult patients are infected with serotype 3, showing that this serotype threatens high-risk groups the most.

When infected with serotype 3, patients are prone to develop conditions such as septic shock, meningitis, severe pneumonia, pulmonary oedema, and heart disease. The mortality rate for patients with multiple comorbidities can reach up to 47%. Furthermore, studies have shown that serotype 3 will develop resistance to antibiotics, including commonly used erythromycin and tetracycline, with resistance rates surpassing 55% and 70% respectively, making treatment more challenging.

Prevention is better than cure. The recently introduced pneumococcal 15‑valent conjugate vaccine effectively targets serotype 3. It is already registered in Hong Kong, and citizens can receive it at private medical institutions at their own expense. With just one dose, it can prevent up to 15 types of pneumococci, including serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 22F, 23F, and 33F. It is highly effective in preventing serotype 3 infections.

In infants, the 15-valent vaccine generates 73% higher immunogenicity against serotype 3 compared to the 13-valent vaccine. For adults aged 50 or above, the 15-valent vaccine provides 60% higher immunogenicity against serotype 3 compared to the 13-valent vaccine. This demonstrates that the 15-valent vaccine can specifically target serotype 3. It can also maintain its efficacy for up to 10 years, serving as the best preventive method against pneumococcal infections.

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