Immunisations and Vaccines
Routine and additional immunisations, pneumococcal and flu vaccines, vaccination advice, and a sample parent letter
Immunisations
See: UK Government's current Complete routine immunisation schedule.
Additional Immunisations
Pneumococcal Immunisation
An additional pneumococcal immunisation is now universally agreed (from Autumn 2019 onwards) for every child with Down Syndrome and not only those at "high-risk:: via GP/practice nurse. From 2 years of age: single dose of Pneumovax II (also known as PPV 23, as it protects against 23 different pneumococcal strains). The PPV vaccine is not effective under 2 years of age, hence why they receive the PCV.
Influenza Immunisation
- First vaccine (2 doses 4 weeks apart) from 6 months.
- Annually for life after this.
- Please note that, under 2 years of age, this is an injectable immunisation, and over 2, nasal administration can be offered.
Chickenpox and Vaccines
Vaccines for children with Down Syndrome are under review (2019), and more guidance will be published, including, e.g. the VZV vaccine against chickenpox. For now, professionals need to have a low threshold to consider this vaccine if evidence of immunocompromise, as there have been serious cases of VZV pneumonitis in DS. Also inform GP and parents that sometimes children with Down Syndrome don't show the typical signs and symptoms of chickenpox as other children, so professionals need to consider chickenpox even if it presents in an atypical way, be aware of the complications and monitor them more closely.
Information on Covid Vaccine and T21 Covid Research
- See information on the Down's Syndrome UK website.
Immunisation and Reports to GPs
Include in every report to the GP about the recommended extra vaccinations - annual flu vaccine and the extra pneumococcal vaccine. (There will also be routine letters being distributed around Autumn to GPs to remind them about these vaccinations due for ALL children with Down Syndrome). Ideally, too, ensure that these children are given the first batches of flu vaccine that are made available for the GPs.
Also, have a statement at the end of each report about the increased risk of infection, and that in Down Syndrome, these infections can sometimes present atypically. There is information in the new insert for the PHCR/red book about this as well.
Further Research
Archives of Diseases of Childhood (Nov. 2018)
- All children with Down Syndrome should have annual influenza vaccines from 6 months of age.
- 23-valent pneumococcal vaccine from 2 years.
- Consideration should be given to meningococcal ACWC (and Meningococcal B if not already given).
- Long-term immunogenicity of vaccines is unknown in this group and may require boosters.
- Recurrent vaccine-preventable diseases may have a negative impact on long-term outcomes.