Burden of Disease
Burden of IPD in Singapore
Adapted from Communicable Diseases Surveillance, Singapore (2018).1 
The risk & incidence of invasive pneumococcal disease is highest in the youngest & oldest age groups.1 Amongst those in the age group of 0-4 years of age, the resident incidence rate of reported invasive pneumococcal disease cases was 2nd highest at 4.3 per 100,000.1​

Serotype 19A
Prior to the introduction of PCV13, Serotype 19A was a leading cause of serious pneumococcal disease worldwide, with increasing prevalence.2-8​
Compared to PCV7 & PCV10, PCV13 is the only pneumococcal conjugate vaccine that offers protection against Serotype 19A.9,10​

Studies on Serotype 19A
PCV13 Had a Rapid and Sustained Impact on Serotype 19A IPD in Children < 5 Years of Age, United Kingdom
 In the United Kingdom, there was a demonstrated 87% reduction in Serotype 19A IPD in children <5 years of age in the post-PCV13 period (2016-2017) as compared to the pre-PCV13 period (2008-2010).11​

Belgium: Trend in Reported Serotype 19A IPD cases in Children 0-2 Years of Age
In Belgium, the total reported IPD and Serotype 19A IPD cases in children 0-2 years of age was the lowest during the period when PCV13 was recommended. After PCV13 was replaced by PCV10, the data suggests an increase in the number of serotype 19A IPD cases among children 0-2 years of age through 2018.12​
*Pneumococci samples were isolated from blood, lumbar fluid, pleura, and joint fluid.14​
IPD=invasive pneumococcal disease; NIP=national immunization program. PCV7 as mentioned above is presently not registered in Singapore.​
NCIS Recommendations
For All Children Age 0 -12 months
Catch-Up Programme
Revised catch-up immunisation schedule for pneumococcal vaccine 
MOH recommends catch-up immunisation for all previously unimmunised children under 5 years of age, as the rates of invasive pneumococcal disease is highest in this agegroup,
after the elderly.
For previously unimmunised children below 12 months of age, 2 doses for the primary series and 1 booster dose (at aged 12-24 months) should be given. The recommended interval between the first and second dose is eight weeks, with a minimum interval of 4 weeks. The minimum interval between the second dose of the
primary series and the booster dose is eight weeks.
For previously unimmunised children between 12 to 23 months of age, 2 doses of PCV should be given with a minimum interval of 8 weeks between doses.
For previously unimmunised children between 24-59 months of age who have asplenia or splenic dysfunction, or who are immunocompromised and may have a suboptimal response to the first dose of vaccine, should receive 2 doses of PCV, with an interval of 8 weeks between doses.
For all other previously unimmunised children between 24-59 months of age, a single dose of PCV is to be administered.
Catch-Up Programme
Revised catch-up immunisation schedule for pneumococcal vaccine 
MOH recommends catch-up immunisation for all previously unimmunised children under 5 years of age, as the rates of invasive pneumococcal disease is highest in this agegroup,
after the elderly.
For previously unimmunised children below 12 months of age, 2 doses for the primary series and 1 booster dose (at aged 12-24 months) should be given. The recommended interval between the first and second dose is eight weeks, with a minimum interval of 4 weeks. The minimum interval between the second dose of the
primary series and the booster dose is eight weeks.
For previously unimmunised children between 12 to 23 months of age, 2 doses of PCV should be given with a minimum interval of 8 weeks between doses.
For previously unimmunised children between 24-59 months of age who have asplenia or splenic dysfunction, or who are immunocompromised and may have a suboptimal response to the first dose of vaccine, should receive 2 doses of PCV, with an interval of 8 weeks between doses.
For all other previously unimmunised children between 24-59 months of age, a single dose of PCV is to be administered.
Catch-Up Programme
Revised catch-up immunisation schedule for pneumococcal vaccine 
MOH recommends catch-up immunisation for all previously unimmunised children under 5 years of age, as the rates of invasive pneumococcal disease is highest in this agegroup,
after the elderly.
For previously unimmunised children below 12 months of age, 2 doses for the primary series and 1 booster dose (at aged 12-24 months) should be given. The recommended interval between the first and second dose is eight weeks, with a minimum interval of 4 weeks. The minimum interval between the second dose of the
primary series and the booster dose is eight weeks.
For previously unimmunised children between 12 to 23 months of age, 2 doses of PCV should be given with a minimum interval of 8 weeks between doses.
For previously unimmunised children between 24-59 months of age who have asplenia or splenic dysfunction, or who are immunocompromised and may have a suboptimal response to the first dose of vaccine, should receive 2 doses of PCV, with an interval of 8 weeks between doses.
For all other previously unimmunised children between 24-59 months of age, a single dose of PCV is to be administered.
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PP-PRV-SGP-0080/24AUG2022

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