Will Flanders widen pneumococcal vaccination after four child deaths?

The Flemish Department of Care is evaluating a switch to a broader childhood pneumococcal vaccine after four children in Flanders died from invasive infections caused by serotype 12F since the beginning of 2025. VRT NWS reported that two babies died in 2025 and two more young children in the first half of 2026. The bacterial variant responsible is not covered by the 13-valent vaccine currently supplied free through the Flemish childhood programme.

For parents in Flanders, the immediate difficulty is that two levels of protection now coexist. Babies routinely receive three free doses of PCV13 through Kind en Gezin

Pneumococci commonly inhabit the nose and throat without causing illness. In rare cases, however, the bacteria invade normally sterile parts of the body and cause pneumonia, meningitis or sepsis. The Flemish Department of Care identifies children under two, older people and people with weakened immunity as groups at greater risk of severe disease. Urgent medical assessment remains essential when a child becomes seriously unwell; vaccination reduces risk but does not replace diagnosis and treatment.

The present concern is not evidence that PCV13 has stopped working against its intended targets. In its public explanation, the Department said the vaccine “works well” and that the serotypes it covers have been strongly suppressed among young children. The problem is serotype replacement: as vaccine-covered strains decline, other variants can account for a larger share of disease. Serotype 12F is among the additional types covered by PCV20.

Belgium’s Superior Health Council recommended PCV20 for routine childhood vaccination in April 2025. Its preferred schedule uses four doses, broadening protection but adding an appointment and increasing procurement costs. The Belgian Centre for Pharmacotherapeutic Information noted in July 2026 that the communities had not yet implemented that advice and were still using three PCV13 doses. Childhood vaccination is organised by Belgium’s communities, so the federal expert recommendation does not itself change what Kind en Gezin or its French-speaking counterpart ONE supplies.

That division of responsibility explains the apparently conflicting messages. The Superior Health Council’s clinical perspective favours wider serotype coverage. The Flemish Department of Care says it is examining the financial and organisational consequences through a health-economic assessment while monitoring infections and circulating strains. In federal parliament in November 2025, Health Minister Frank Vandenbroucke described PCV13 as “an excellent vaccine” pending that work, while confirming that implementation belongs to the communities.

The European context supports vaccination while leaving product choices largely national or regional. The European Centre for Disease Prevention and Control says childhood immunisation is the most effective public-health measure against invasive pneumococcal disease and can also protect unvaccinated people by reducing circulation of covered strains. It cautions that surveillance systems differ across Europe, making direct comparisons between countries difficult.

There is nevertheless a sign that Flemish policy is moving. The Department of Care’s procurement page lists an open procedure for PCV20 supplies for the Flemish immunisation programme in 2027, with bids due on 10 September 2026. That indicates concrete preparation, although it does not by itself establish a start date, final schedule or eligibility rules.

Families should not postpone the vaccines already offered while awaiting a policy decision. The Department advises parents who are considering switching from PCV13 to PCV20—particularly when a child has medical risk factors—to speak with their doctor or Kind en Gezin. The next decisive information will be the outcome of the economic evaluation, the 2027 procurement process and updated surveillance showing whether serotype 12F continues to rise.