Pneumococcal disease, invasive

Reporting Obligations

Individuals with suspect or confirmed cases must be reported to the Thunder Bay District Health Unit by the next working day by fax, phone or mail.

• Fax: (807) 625-4822
• Phone: 625-8318 or toll-free at 1-888-294—6630, ext. 8318
• Mail: 999 Balmoral Street, Thunder Bay, ON P7B 6E7

 

Epidemiology

TBDHU Invasive Pneumococcal Disease (IPD) Update

• IPD increase: TBDHU has seen an increase of invasive pneumococcal disease (IPD) in the TBDHU area over the past 2 to 3 years with a total of 63 cases reported in 2023, 77 cases in 2024 and 95 cases in 2025 (as of November 14).
• Higher than pre-pandemic: The numbers are now higher than pre-pandemic years. The numbers during the pandemic years were lower.
• Primarily Thunder Bay: This increase in cases can be primarily seen in the Thunder Bay area; additionally, the larger population size makes it easier to see clear trends over time.
• District cases: While cases of IPD are also occurring in District communities and in First Nations communities, definitive increases have not been seen at this time; however, the smaller populations of these areas result in more variable case counts year over year.

TBDHU Data for 2025

• 55% of cases are in individuals 50 years of age and older
• 68% have been hospitalized
• 11% admitted to ICU
• 78% of cases had subtypes that are covered by the Prevnar 20 vaccine*
• Top risk factors:
  • 82% - Unimmunized
  • 58% - Chronic disease/underlying medical condition

Source: iPHIS, Ontario Ministry of Health; extracted Nov 14, 2025.
 
*Note that not all may have been eligible under the current eligibility criteria for publicly funded vaccine.'

Additional TBDHU Information

• The increase in cases in 2025 is driven by increased cases in individuals over 50 years of age, when compared to 2024.
• In 2024, substance use disorders (including alcohol abuse, inhalation drug use, and injection use), contributed to the increase that year, including in adults less than 50.
• 20-30% of IPD cases in TBDHU in recent years are in individuals who are underhoused or who are experiencing homelessness.
  • TBDHU works with partners to provide access to the vaccine in this population.
• Individuals under 30 years of age accounted for less than 10% of all cases in 2024 and 2025.
  • These cases are mostly in those aged 20-29 years.
  • There have been <5 cases of IPD in individuals under 20 years of age over the last two years.

Provincial

• Public Health Ontario (PHO) monthly provincial updates -  Infectious Diseases at a Glance

 

Vaccine Recommendations

65 years and older:

• All individuals 65 years of age and older are eligible for one dose, if they have not had the vaccine before.
• A second dose of pneumococcal vaccine is available to those who are 65 years and older with a chronic disease or underlying medical condition IF it has been at least one year since their last dose.

High Risk Eligibility:

• Continue to assess for high-risk vaccine eligibility with individuals of all ages and immunize as appropriate for those who meet the criteria as outlined in the Ministry of Health Care Provider Fact Sheets:
  • Individuals 18 years+
  • Individuals 6 weeks-17 years

Maintain Low Threshold for Vaccination:

Given the increased rate of IPD in TBDHU:

• 50 and older: Please maintain a low threshold for providing the pneumococcal vaccine to individuals 50 years and older, if you suspect that they may have a condition on the list, even if they do not have a confirmed diagnosis.
• Substance use disorder: Please provide the pneumococcal vaccine to individuals with substance use disorder if they are 40 years and older, even if they do not have a confirmed diagnosis on the list. This is under the direction of the Medical Officer of Health, given the current context.

Routine vaccines for children:

• Continue to encourage vaccination under Ontario’s Publicly Funded Schedule for all children when communicating with parents and guardians.

Vaccine Products 

• Pneu-C-15 has replaced Pneu-C-13
• Pneu-C-20 has replaced Pneu-P-23

Vaccine Orders:

• Order form

Patient Resources:

• Patient factsheet (en français).

Other Resources:

• Canadian Immunization Guide: Pneumococcal vaccines (en francais)
• Public Health Agency of Canada Pneumococcal Disease Factsheet (en français).

Public Health Guidance

Infectious Disease Protocol: Appendix 1 (May, 2022) includes:

• Case Definition/Outbreak Definition
• Clinical Information
• Laboratory Evidence
• Case and Contact Management
• Outbreak Management
• Prevention and Control Measures
• Disease Characteristics

Laboratory Services – Public Health Ontario (PHO)

• Streptococcus pneumoniae – Real-time PCR
• Streptococcus pneumoniae – Serotyping

Public Health Ontario – Additional Resources

• Public Health Ontario

Additional Resources

• Government of Canada

Questions

• Vaccine: Contact Vaccine Preventable Diseases at 807-625-5908; toll-free at 1-888-294-6630.
• Invasive Pneumococcal Disease: Contact Infectious Diseases at 807-625-8318; toll-free at 1-888-294-6630 (ext. 8318)