Updated schedule of pneumococcal vaccination to be implemented under Childhood Immunisation Programme

     The Centre for Health Protection (CHP) of the Department of Health (DH) today (April 10) announced that starting from July this year, children born in 2019 will receive two primary doses and one booster dose of pneumococcal conjugate vaccine (PCV) instead of the current schedule of three primary doses and one booster dose under the Hong Kong Childhood Immunisation Programme (HKCIP).
​     The updated schedule is implemented following the latest recommendations on the use of PCV made by the Scientific Committee on Vaccine Preventable Diseases (SCVPD) under the CHP, after reviewing the local epidemiology of invasive pneumococcal disease, scientific evidence on pneumococcal vaccination, as well as recommendations from the World Health Organization (WHO) and overseas health authorities recently.
​     PCV was incorporated into the HKCIP in September 2009 and 13-valent PCV (PCV13) has been used since December 2011. Currently, eligible children receive a primary series of three doses of PCV13 at two, four and six months, followed by a booster dose at 12 months (referred as "3p+1 schedule").
​     The WHO recommended a 3-dose PCV schedule for infants, either three primary doses without booster (referred as "3p+0 schedule") or two primary doses plus a booster dose (referred as "2p+1 schedule"). According to the scientific evidence reviewed by the WHO, both schedules are effective in reducing vaccine-type carriage and diseases. Additionally, a single dose catch-up vaccination can be offered to those initiating PCV at 24 months and older. These recommendations have been reiterated in the WHO's latest position paper published in February 2019. Of note, the WHO pointed out that the 2p+1 schedule has potential benefits over the 3p+0 schedule as higher antibody levels are induced in the second year of life, which may be important in maintaining herd immunity.
​     The SCVPD noted that about 85 per cent of countries that have introduced PCV in their childhood immunisation programmes have adopted a 3-dose schedule as recommended by the WHO.
​     A spokesman for the CHP said, "In view of the latest scientific evidence, the SCVPD recommends that the administration of PCV13 under the HKCIP be changed from the 3p+1 schedule to the 2p+1 schedule. Under the updated schedule, children will receive two primary doses of PCV13 at two and four months, followed by a booster dose of PCV13 at 12 months. The change will simplify the vaccination schedules of the HKCIP with one vaccine spared at six months.
​     "Based on the available evidence and overseas experience, the SCVPD regarded that the 2p+1 schedule is non-inferior to the current 3p+1 schedule and should provide comparable protection against invasive pneumococcal disease to children in Hong Kong."
​     Meanwhile, the SCVPD also updated its previous recommendation on catch-up PCV vaccination. Under the updated recommendation, a single dose of PCV13 catch-up vaccination should be provided to children who have not received any booster dose of PCV13 between the age of one year and less than six years.
​     "Starting from July 2019, the Maternal and Child Health Centres (MCHCs) of the DH will implement the updated 2p+1 schedule for eligible children born on or after January 1, 2019. These children will no longer receive PCV13 at their six-month visit in MCHCs. Catch-up vaccination will also be provided to children who have not received any booster dose of PCV13 between the age of one year to less than six years as appropriate," the spokesman said.
​     The updated recommendations on PCV13 and the latest schedule of the HKCIP recommended by the SCVPD has been uploaded onto the following webpage: www.chp.gov.hk/en/static/24008.html. The public may visit the CHP's webpages for more information on pneumococcal infection and invasive pneumococcal disease.

Ends/Wednesday, April 10, 2019
Issued at HKT 14:15