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20160425222517 Ben  
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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