Pneumonia vaccines are designed to prevent disease caused by various serotypes or strains of the bacteria streptococcus pneumonia. The recommendations for use of these vaccines recently changed, and what to do can sometimes be confusing. The Centers for Disease Control and Prevention (CDC) revised their recommendations for pneumonia vaccines in August of 2014. While I find discussing the vaccine very interesting, if you do not, just skip to the last paragraph of this blog, and you will have the basic facts you need to know!
First, let’s talk about pneumococcal disease, a serious infection that can cause pneumonia, meningitis, and bloodstream infections. Each year about 1 million adults in the USA get pneumococcal pneumonia, and 5-7 per cent of those die from it. The death rates are considerably higher for those over 65 years of age. The symptoms of pneumococcal pneumonia can include high fever, chills, cough, shortness of breath, chest pain, and disorientation. This type of pneumonia can progress to a serious infection very rapidly. While antibiotic treatment is often successful, the best treatment for this problem is to prevent it. There are about 90 serotypes of streptococcus pneumonia identified, but only a few of these cause the majority of serious pneumococcal disease.
There are currently 2 pneumonia vaccines recommended for adults over age 65. The first is pneumococcal polysaccharide vaccine (PPSV23), commonly known as Pneumovax. This vaccine has been around for years, and is recommended as a routine immunization for adults age 65 and over. It protects against 23 of the serotypes of pneumococcus bacteria, and is usually given just once. There are special circumstances where a physician might advise a second PPSV 23, but that is not usually the case. About half the people who get this vaccine have mild side effects such as redness or soreness at the injection site. Less than 1% develop fever, muscle aches, or more severe local reactions.
The second pneumonia vaccine now available is Prevnar-13 (PCV13). As of August, 2014, the CDC recommends that all adults age 65 and over receive 1 dose of this vaccine as well. PCV13 protects against 13 serotypes of pneumococcus, and is quite effective against the serotypes that cause half of the serious pneumococcal infections in adults. Its potential side effects are similar to those of PPSV23.
The CDC recommends that PCV13 be given first if a senior has never had either of these vaccines. If someone has already had the PPSV23, the PCV13 can successfully be given later. These 2 vaccines should not be given together. Until recently, Medicare Part B would pay for only one vaccine, but the good news is that both vaccine doses are now covered as of February 2, 2015. It is important to note that PCV13 and PPSV23 must be given at least 12 months apart in order to have them be both effective and covered by Medicare.
Influenza vaccine can be given at the same time as either of the pneumonia vaccines, but they should then be given in opposite arms. If a person has had a serious reaction to a vaccine in the past, they should discuss with their physician the decision of whether or not to take the pneumonia vaccine. Keep in mind that pneumonia vaccines prevent only the types of pneumonia caused by streptococcus pneumonia, not all kinds of pneumonia, and they are not substitutes for a yearly influenza vaccine. The PCV13 and PPSV23 vaccines are available though many local health departments, immunizing pharmacies, and primary health care providers. If you have had 1 pneumonia vaccine, it is very important to know which one you had in order to know which one to get next.
Here is the bottom line. The pneumonia vaccines are quite safe, and they are very helpful in preventing potentially life threatening disease. They are recommended for virtually all adults age 65 and over. If you have never had a pneumonia vaccine, you should get the Prevnar-13 (PCV13) first, and then the Pneumovax (PPSV23) at least 12 months later. If you have already had the PPSV23, get the PCV13 at least 12 months later. Let’s work to prevent this disease rather than waiting to take our chances in treating it!
AgeSmart would like to thank Dr. Thomas Dawdy for this week’s blog.