Prepared by: Luka Kosec Last modified: March 2025

Purpose and justification of the indicator

The causative agents of pneumococcal infections (pneumococcus) are normally present in the mucous membranes of the respiratory tract of healthy carriers, and are transmitted between people through close contact with infectious droplets. The most at risk are young children (up to two years of age), the elderly, people with chronic diseases and immunodeficiencies. They most often cause otitis media, less often pneumonia, and sometimes invasive pneumococcal infections (meningitis, sepsis, invasive pneumonia), which can also result in death. In Slovenia, as well as in other European countries and North America, where regular vaccination against pneumococcus has been introduced, the frequency of invasive pneumococcal infections has decreased significantly. The causative agents are becoming increasingly resistant to many antibiotics, which makes the treatment of these infections more difficult, which is why their prevention through vaccination is all the more important. According to the National Vaccination Program, the recommended vaccination of children with the pneumococcal conjugate vaccine begins at the age of 3 months. After completing the primary regimen, children receive a booster dose between 11 and 18 months of age. Pneumococcal conjugate vaccines contain multiple pneumococcal serotypes and thus have a significant impact on reducing the burden of invasive pneumococcal disease. Continuous monitoring of circulating pneumococcal serotypes is essential for effective prevention of pneumococcal infections, as this allows for the rapid detection of new serotypes, especially those that develop resistance to antibiotics. In addition, the use of updated vaccines, which include a larger number of serotypes than previous generations of vaccines, is important, as this helps to prevent the spread of resistant variants.

Definition of indicator

Vaccination coverage of children against pneumococcal infections in the observed period describes the proportion of children from a specific birth cohort for whom vaccination against pneumococcal infections is recommended in accordance with the National Vaccination Program who were vaccinated with three doses of the vaccine against pneumococcal infections, calculated as a percentage of all children from the same birth cohort.

Unit of measure

Calculation of the indicator

Vaccination coverage of children against pneumococcal infections is the ratio between the number of children from a given birth cohort who have been vaccinated with three doses of the pneumococcal vaccine and the total number of children from that same birth cohort. Vaccination of children with 3 doses of pneumococcal vaccine (FORMULA) The calculation of the indicator takes into account all children who meet the above conditions, are registered in eRCO and have a temporary or permanent address of residence in Slovenia. Vaccination coverage by municipality is shown according to address of residence.

Data sources for Slovenia

eRCO – Electronic registry of vaccinated persons and adverse reactions after vaccination.

Time availability

Year of publication of the indicator in Health in the municipality

Reference year 2023 (children born in 2021), annually

Men in literature

1. National Institute of Public Health. Child vaccination: basic information about vaccination against pneumococcal infections [internet]. [cited on 25. 9. 2024]. Available at: https://nijz.si/wp-content/uploads/2022/11/2020_pnevmokok.pdf. 2. CDC. Antibiotic-resistant Streptococcus pneumoniae [Internet]. [cited 2024-09-25]. Available at: https://www.cdc.gov/pneumococcal/php/drug-resistance/index.html 3. Kristina L Bajema, Ryan Gierke, Monica M Farley, William Schaffner, Ann Thomas, Arthur L Reingold, Lee H Harrison, Ruth Lynfield, Kari E Burzlaff, Susan Petit, Meghan Barnes, Salina Torres, Paula M Snippes Vagnone, Bernard Beall, Tamara Pilishvili, Impact of Pneumococcal Conjugate Vaccines on Antibiotic-Nonsusceptible Invasive Pneumococcal Disease in the United States, The Journal of Infectious Diseases, Volume 226, Issue 2, 15 July 2022, Pages 342–351. 4. Pavia M, Bianco A, Nobile CG, Marinelli P, Angelillo IF. Efficacy of pneumococcal vaccination in children younger than 24 months: a meta-analysis. Pediatrics. 2009 Jun;123(6):e1103-10. Hascelik G, Soyletir G, Gulay Z, Sancak B, Yaman A, Gurler N, Aydemir SS, Bayramoglu G, Aydin F, Cekin Y, Birinci A, Ozakin C, Akpolat N, Ozhak Baysan B, Gultekin M, Zer Y, Sanal L, Arabaci C, Ay Altintop Y, Ozturk C, Ceyhan M. Serotype distribution of Streptococcus pneumoniae and pneumococcal vaccine coverage in adults in Turkey between 2015 and 2018. Ann Med. 2023 Dec;55(1):266-275

Notes

It is assumed that all children from a given birth cohort had the opportunity to be vaccinated by the reference period to which the data refer (e.g.: for the reference year 2023, this is the cohort of children born from 1 January to 31 December 2021). Reporting on vaccinations in eRCO is not optimal, so the vaccination coverage shown in this indicator is slightly underestimated compared to the actual vaccination of children against pneumococcal infections in Slovenia. Therefore, at the NIJZ, we additionally check the vaccination of children against pneumococcal infections with 3 doses of the vaccine on a random sample of children every year.

Preventive

Prepared by: Metka Zaletel 
Date of last modification: September 2016

Residents and community

Prepared by: Mojca Simončič and Metka Zaletel 
Date of last change: January 2018

Prepared by: Mojca Simončič and Metka Zaletel 
Date of last change: September 2016

Prepared by: Mojca Simončič 
Date of last change: March 2017

Prepared by: Gregor Starc 
Date of last modification: September 2016

Health risk factors

Prepared by: Gregor Starc, Kristina Orožen 
Date of last change: September 2016

Prepared by: Tina Lesnik 
Date of last change: March 2021

Prepared by: Andreja Belščak 
Date of last change: September 2016

Prepared by: Mateja Rok Simon and Tina Zupanič 
Date of last change: March 2017

Prepared by: Metka Zaletel 
Date of last modification: March 2019

Prepared by: Victoria Zakrajšek 
Date of last change: March 2021

Prepared by: Martin Ranfl, Jona Bambič 
Date of last change: November 2017

Prepared by: Victoria Zakrajšek, Tatjana Kofol Bric 
Date of last change: March 2019

Prepared by: Jasmina Staroveški Anderlič 
Date of last change: March 2020

Prepared by: Victoria Zakrajšek 
Date of last change: November 2021

Prepared by: Victoria Zakrajšek 
Date of last change: March 2023

Prepared by: Tatjana Kofol Bric 
Date of last modification: September 2016

Prepared by: Victoria Zakrajšek and Sonja Tomšič 
Date of last change: March 2017

Prepared by: Bonia Miljavac 
Date of last change: March 2017

Prepared by: Sonja Tomšič 
Date of last change: November 2019

Prepared by: Luka Kosec Last modified: March 2025


Prepared by: Sonja Tomšič 
Date of last change: March 2021

Health status

Prepared by: Victoria Zakrajšek 
Date of last change: March 2017

Prepared by: Aleš Korošec 
Date of last change: September 2016

Prepared by: Aleš Korošec
Date of last change: September 2016

Prepared by: Tatjana Kofol Bric 
Date of last change: March 2019

Prepared by: Aleš Korošec and Sonja Tomšič 
Date of last change: September 2016

Prepared by: Mojca Simončič and Metka Zaletel 
Date of last change: October 2019

Prepared by: Kristina Orožen 
Date of last change: March 2019

Prepared by: Tatjana Kofol Bric, Jona Bambič 
Date of last change: March 2018

Prepared by: Victoria Zakrajšek, Tatjana Kofol Bric 
Date of last change: February 2020

Prepared by: Ema Ahačič 
Date of last change: April 2023

Prepared by: Ema Ahačič 
Date of last change: March 2023

Mortality

Prepared by: Sonja Tomšič, Tatjana Kofol Bric 
Date of last change: March 2019

Prepared by: Sonja Tomšič 
Date of last change: March 2019

Prepared by: Tina Lesnik 
Date of last change: March 2019

Prepared by: Tina Lesnik 
Date of last change: March 2020