Pneumococcal Vaccine Timing and Effectiveness for Children

Pneumococcal vaccine injection

Dear Doctor,
Hello.
My daughter received her first dose of the pneumococcal vaccine at 13 months old.
The second dose was originally scheduled for 16 months, but it was postponed due to a cold.
A few days ago, at 17 months, she was unable to receive the vaccine again due to a high temperature (she had a fever after the first dose).
I would like to ask the following questions:
1.
Will the interval between the first and second doses affect the vaccine's efficacy? What is the maximum recommended interval?
2.
Is it acceptable to only receive the first dose and not the second?
3.
If only the first dose is given, can a booster be administered between the ages of 2 to 5 years?
4.
Is an ear temperature consistently between 37.2°C and 37.4°C considered normal?
Thank you!

Danxin de mama, 30~39 year old female. Ask Date: 2007/10/18

Dr. Xiao Kaiwen reply Pediatrics

(1) The intervals established after the vaccine development process are designed to produce the best immune response, rather than focusing on the maximum duration between doses.
The general principle is that the longer the interval, the more limited the vaccine's effectiveness will be, which increases the risk of infection during that period.
However, if the interval is extended, there is no need to administer a booster dose of the first shot.
(2) Similarly, insufficient doses will result in reduced vaccine effectiveness, potentially leading to ineffectiveness and an increased risk of infection.
(3) The pneumococcal vaccine is typically administered as a single dose for individuals over the age of 2, so it is certainly acceptable; however, caution should be exercised regarding the risk of infection in children under 2 years old.
(4) Measuring ear temperature is convenient but can be influenced by various factors, such as in infants under 6 months where the ear canal may not be straightened or earwax may obstruct the measurement, leading to inaccuracies.
It is recommended to compare it with axillary temperature, which is less prone to interference (an ear temperature of 37.5°C and an axillary temperature above 37°C is considered a fever).
If the ear temperature consistently falls between 37.2°C and 37.4°C (which is defined as not having a fever), it is advisable to consult a pediatrician, especially if there are no concerns regarding activity levels or appetite.

Reply Date: 2007/10/18

More Info

Dear Patient,
Thank you for your questions regarding the pneumococcal vaccine for your daughter. It's great that you are being proactive about her health. Let’s address your concerns one by one.

1. Interval Between Doses: The pneumococcal vaccine is typically administered in a series, with the first dose given at 2 months of age, followed by additional doses at 4 months, 6 months, and a booster dose at 12-15 months. The recommended interval between the first and second doses is generally 4 to 8 weeks. However, if the second dose is delayed due to illness, it is still important to complete the vaccination series. While there is no strict maximum interval, it is advisable to administer the second dose as soon as possible to ensure optimal immunity. Delays beyond a few months may reduce the effectiveness of the vaccine, but it is still better to receive the vaccine late than not at all.

2. Receiving Only the First Dose: If your daughter only receives the first dose and does not receive the second dose, she will not have the full protection that the complete vaccination series provides. The first dose does offer some level of immunity, but it is not sufficient for long-term protection against pneumococcal diseases, which can be serious. Therefore, it is crucial to complete the series as recommended.

3. Receiving the Second Dose Later: If your daughter only receives the first dose and then receives another dose between the ages of 2 to 5 years, this is generally acceptable. The Centers for Disease Control and Prevention (CDC) guidelines indicate that if a child has missed doses, they should receive them as soon as possible. However, it is essential to consult with your pediatrician to determine the best timing for the additional doses based on her specific health situation.

4. Normal Temperature Range: Regarding your concern about her ear temperature consistently being between 37.2°C and 37.4°C (99°F to 99.3°F), this range is generally considered to be within the normal limits for children. Normal body temperature can vary based on the time of day, activity level, and method of measurement. However, if you notice any other symptoms or if her temperature rises significantly, it would be wise to consult your healthcare provider.

In summary, it is important to complete the pneumococcal vaccination series to ensure your daughter has adequate protection against pneumococcal diseases. If there are delays, try to schedule the missed doses as soon as she is well. Always consult your pediatrician for personalized advice, especially if you have concerns about her health or vaccination schedule.

Wishing you and your daughter good health!
Best regards,
Doctor Q&A Teams

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