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usually one-off but every 5 years if splenectomy/asplenia or CKD
two type of pneumococcal vaccine
pneumococcal conjugate vaccine (PCV) - kids at 2,4,13 months
pneumococcal polysaccharide vaccine (PPV) - adults
For PPV - all >65 and
asplenia or splenic dysfunction
chronic respiratory disease: COPD, bronchiectasis, cystic fibrosis, interstitial lung disease. (Asthma if 'it requires the use of oral steroids at a dose sufficient to act as a significant immunosuppressant')
chronic heart disease: ischaemic heart disease if requiring medication or follow-up, heart failure, congenital heart disease. Controlled hypertension is not an indication for vaccination
chronic kidney disease
chronic liver disease: including cirrhosis and chronic hepatitis
diabetes mellitus if requiring medication
immunosuppression (either due to disease or treatment). This includes patients with any stage of HIV infection
cochlear implants
patients with cerebrospinal fluid leaks