Table 2.
Recommendations for 7-valent pneumococcal conjugate vaccine use in individuals by selected countries of Europe (reviewed January 2006)
| Risk-based recommendations | AUT | BEL | DEU* | DNK | ESP | FIN | FRA | GBR† | GRC | IRL | ISL | ITA‡ | LUX | NLD | NOR | PRT | SWE§ |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Medical comorbidities | |||||||||||||||||
| Splenic dysfunction** | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |||||||
| Immunodeficiency †† | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓‡‡ | ✓ | |||||||
| Chronic disease§§ | ✓ | ✓ | ✓¶¶ | ✓ | ✓¶¶ | ✓¶¶ | ✓ | ✓ | ✓¶¶ | ✓¶¶ | |||||||
| CSF leak | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |||||||
| Diabetes mellitus | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||||||||||
| Cochlear implant | ✓ | ✓ | ✓ | ✓ | ✓ | ||||||||||||
| Previous IPD infection | ✓ | ✓ | ✓ | ||||||||||||||
| ‘Any other at-risk pathology’ | ✓ | ✓ | |||||||||||||||
| Predisposing conditions | |||||||||||||||||
| Developmental delay | ✓ | ✓ | |||||||||||||||
| Failure to thrive | ✓ | ✓ | |||||||||||||||
| Premature | ✓ | ✓ | |||||||||||||||
| Low birth weight | ✓ | ✓ | |||||||||||||||
| Other considerations | |||||||||||||||||
| Day care | ✓*** | ✓ | |||||||||||||||
| Family with >2 children | ✓ | ||||||||||||||||
| Breast feeding <2 months | ✓ | ||||||||||||||||
| Age-based policy (children <5 years old) – private physicians | ✓††† | ✓††† | ✓††† | ✓††† | ✓††† | ✓††† | ✓††† | ✓††† | ✓††† | ✓‡‡‡ | ✓††† | ✓††† | ✓††† | ||||
| National (regional) immunisation programs | ✓ | ✓ | (✓) | ✓ | ✓ | (✓) | ✓ | ✓ | |||||||||
AUT, Austria; BEL, Belgium; DEU, Germany; DNK, Denmark; ESP, Spain; FIN, Finland; FRA, France; GBR, United Kingdom; GRC, Greece; IRL, Ireland; ISL, Iceland; ITA, Italy; LUX, Luxembourg; NLD, Netherlands; PRT, Portugal; SWE, Sweden.
The German STIKO extends the risk-based recommendations to children <5 years of age. (July 2005).
Universal recommendations are anticipated in 2006 in Great Britain.
Three regions have universal recommendations (Liguria, Sicily and Puglia), five have risk-based vaccination programs (Veneto, Lombardia, Lazio, Toscana and Friuli) and one has extended vaccination program (active offer) to day-care subjects (Emilia-Romagna). National Vaccines Committee has approved, in principle, universal recommendations from National Authority, through an offer to all children <24 months of age and a three-dose schedule for newborns.
One region (Örebro) has issued risk-based recommendations.
Including causes of splenic dysfunction such as homozygous sickle cell disease, thallassaemia, asplenia or coeliac disease.
Primary or secondary immunodeficiency (e.g. malignancy such as lymphoma, Hodgkin's disease or leukaemia, immunosuppressive therapy, transplantation or HIV/AIDS. Immunosuppressive therapy is defined in GBR as on or likely to be on systemic steroids for more than a month at a dose equivalent to prednisolone at 20 mg or more per day, any age or for children under 20 kg at a dose of 1 mg or more per kg per day).
Excluding chronic granulomatous disease.
Renal disease including nephrotic syndrome, chronic renal failure, renal transplantation, chronic heart disease such as congenital heart disease or heart failure, lung disease, liver disease including cirrhosis, or neurological disease.
Excluding asthma, apart from asthmas under chronic corticosteroid therapy. [In GBR, ‘chronic lung disease’ includes asthma requiring continuous or repeated use of inhaled or systemic steroids (or with previous exacerbations requiring hospital admission) and includes children who have previously been admitted to hospital for lower respiratory tract infection].
Defined as ‘children kept for more than 4 h/week with more than two children not counting siblings’.
By private physicians, nationwide.
By private physicians, particular regions of the country.