Delivering a Healthy WA
Disease WAtch

Providers reminded of IPD vaccination recommendations for Aboriginal adults

Between 2009 and 2011, the rate of invasive pneumococcal disease (IPD) among Aboriginal people aged 15 to 49 years increased 2.5 times to 135 per 100,000 population (Figure 1). Most cases (80%) had predisposing medical conditions yet only 18% of these had ever received the 23-valent pneumococcal polysaccharide vaccine, Pneumovax 23.

Health providers are reminded that Pneumovax 23 is free for Aboriginal patients aged 15 to 49 years who have a medical condition that predisposes them to IPD (see The Australian Immunisation Handbook 9th ed 2008, page 246).

Graph showing Pneumococcal disease trends in Aboriginal and non-Aboriginal patients aged 15 to 49 years in WA

Figure 1: Pneumococcal disease trends in Aboriginal and non-Aboriginal patients aged 15 to 49 years, WA. (Note: different scales are used on the y-axes.)

The following table shows the schedule for the various adult cohorts for whom Pneumovax 23 is provided free under the National Immunisation Program. The number of doses of Pneumovax 23 required — one, two or three — varies according to the particular cohort’s risk of contracting severe pneumococcal disease. Note that a second dose of Pneumovax 23 is not recommended for healthy adult cohorts (non-Aboriginal adults over 65 years and Aboriginal adults over 50 years).

Immunisation schedule recommendations for Pneumovax 23


Risk group

Pneumovax 23

Dose 1

Dose 2

Dose 3

Non-Aboriginal adults ≥ 65 years

No further doses recommended

Non-Aboriginal adults < 65 years with underlying medical condition or smoker

√ as soon as practicable after diagnosis

√ 5 years after first dose

√ 5 years after second dose OR at 65 years (whichever is later)

Aboriginal adults ≥ 50 years

No further doses recommended

Aboriginal adults 15-49 years with underlying medical condition or smoker

√ as soon as practicable after diagnosis

√ 5 years after first dose

√ 5 years after second dose OR at 50 years (whichever is later)

Asplenic children and adults

√ as soon as practicable after diagnosis

√ 5 years after first dose

√ 5 years after second dose OR at 65 years (for non-Aboriginal adults) OR at 50 years (for Aboriginal adults), whichever is later

Recommendations in the above table are in line with Therapeutic Goods Administration (TGA) advice that a second dose of Pneumovax 23 be considered for patients at high risk of serious pneumococcal disease, provided that at least five years has passed since the previous dose was given.

This advice comes after a cluster of injection site reactions in NSW last year that involved cases who had been given a second dose of Pneumovax 23.

The TGA website has more information on Pneumovax 23 vaccination.

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