Vulnerable Patient Groups

Some conditions increase a person's risk for pneumococcal disease1

As per the National Immunisation Advisory Committee (NIAC) guidelines, the below conditions are associated with an increased risk of invasive pneumococcal disease.1

High risk1

  • Asplenia, hyposplenia (including splenectomy, sickle cell disease, haemoglobinopathies, and coeliac disease)
  • Cancer patients under hospital supervision
  • Chronic renal disease or nephrotic syndrome
  • Cochlear implant candidates and recipients
  • Complement deficiency (particularly C1-C4)
  • CSF leaks (congenital or complicating skull fracture or neurosurgery)
  • Haematopoietic stem-cell transplant
  • Immunosuppressive conditions (e.g. some B- and T-cell disorders, HIV infection, leukaemia, lymphoma), and those receiving immunosuppressive therapies or corticosteroids.
  • Intracranial shunt
  • Solid organ transplant


Medium risk1

  • Children under 5 years of age following invasive pneumococcal disease
  • Chronic heart, lung, or liver disease
  • Diabetes mellitus requiring insulin or oral hypoglycaemic drugs
  • Down syndrome
  • Occupational exposure to metal fumes (i.e. welders)
  • Smokers and alcoholics



  1. NIAC Guidelines Chapter 16: Pneumococcal Infection

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PP-PNA-IRL-0012   Preparation Date: March 2022