People With Health Problems And The Pneumococcal Vaccine
The PPV vaccine is available on the NHS for children and adults aged from 2 to 64 years old who are at a higher risk of developing a pneumococcal infection than the general population.
This is generally the same people who are eligible for annual flu vaccination.
You’re considered to be at a higher risk of a pneumococcal infection if you have:
- a suppressed immune system caused by a health condition, such as HIV
- a suppressed immune system caused by medicines, such as chemotherapy or steroid tablets
- a cochlear implant Action on Hearing Loss has more information about cochlear implants
- had a leak of cerebrospinal fluid this could be the result of an accident or surgery
Adults and children who are severely immunocompromised usually have a single dose of PCV followed by PPV.
Are You 65 Or Older Get Two Vaccinations Against Pneumonia
- By Gregory Curfman, MD, Assistant Professor of Medicine, Former Editor-in-Chief, Harvard Health Publishing
ARCHIVED CONTENT: As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date each article was posted or last reviewed. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
If you or a loved one is age 65 or older, getting vaccinated against pneumonia is a good idea so good that the Centers for Disease Control now recommends that everyone in this age group get vaccinated against pneumonia twice.
This new recommendation is based on findings from a large clinical trial called CAPiTA, which were published today in The New England Journal of Medicine.
Streptococcus pneumoniae, sometimes just called pneumococcus, is a common bacterium that can cause serious lung infections like pneumonia. It can also cause invasive infections of the bloodstream, the tissues covering the brain and spinal cord , and other organs and tissues. Older individuals are especially prone to being infected by Pneumococcus, and these infections are often deadly.
The dark spots are pneumonia-causing Streptococcus pneumoniae bacteria isolated from the blood of an infected person.
One caveat is that while PCV13 is effective in preventing pneumonia caused by S. pneumoniae, it does not prevent pneumonia caused by viruses or other bacteria.
Summary Of Information Contained In This Naci Statement
The following highlights key information for immunization providers. Please refer to the remainder of the Statement for details.
Streptococcus pneumoniae is a bacterium that can cause many types of diseases including invasive pneumococcal disease , and community-acquired pneumonia .
For the prevention of diseases caused by S. pneumoniae in adults, two types of vaccines are available in Canada: pneumococcal 23-valent polysaccharide vaccine containing 23 pneumococcal serotypes and pneumococcal 13-valent conjugate vaccine containing 13 pneumococcal serotypes.
NACI has been tasked with providing a recommendation from a public health perspective on the use of pneumococcal vaccines in adults who are 65 years of age and older, following the implementation of routine childhood pneumococcal vaccine programs in Canada.
Information in this statement is intended for provinces and territories making decisions for publicly funded, routine, immunization programs for adults who are 65 years of age and older without risk factors increasing their risk of IPD. These recommendations supplement the recent NACI recommendations on this topic that were issued for individual-level decision making in 2016.
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Complications Of Pneumonia Caused By Covid
Because pneumonia causes the alveoli in the lungs to fill with pus and fluid, breathing can be painful and difficult.
Pneumonia can cause serious health complications, including:
Because COVID-19 attacks the lungs, it would make sense that having COVID-19 would cause lung complications. As of yet, not enough data are available to support this conclusion.
However, as noted above, research does show that COVID-19 can cause severe illness, including pneumonia that can be fatal. A 2020 study by the CDC found that among a group of people with COVID-19, about 70% had complications from pneumonia. Also, people with COVID-19 were twice as likely to get pneumonia compared to people with the flu.
Regarding long-lasting complications from COVID-19, it is still too soon to say for sure whether “long-haulers” are more likely to have underlying chronic medical conditions.
How To Stay Safe
Given that COVID-19 is a respiratory illness just as pneumonia is, it is important to do your best to minimize your risk of contracting COVID-19, which could potentially cause severe respiratory complications.
The same precautions you’ve been taking to stay safe during the COVID-19 pandemic will, of course, keep you safe from developing pneumonia secondary to COVID-19, too. Be diligent about wearing a well-fitting mask, social distancing, and washing your hands.
A few other tips to keep in mind for recovery from pneumonia are to:
- Control your fever with NSAIDs or acetaminophen .
- Drink plenty of fluids to help loosen secretions and to cough up phlegm.
- Avoid taking cough medicines before talking to your healthcare provider first because coughing is one of the ways your body is working to get rid of the pneumonia infection.
- Drink warm beverages like tea or hot water.
- Use a humidifier, and take steamy baths or showers to help open your airway and ease your breathing.
- Stay away from smoke to allow your lungs to heal themselves. If you are a smoker, this would be a good time to think about quitting.
- Get rest. Stay home and take it easy for a while until you feel better and stronger.
These are all things you can do from the safety and comfort of your own home. Taking care of yourself and seeking medical care as needed can help keep you safe from COVID-19.
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How Long Does A Pneumonia Shot Last
- Younger than 2 years old: four shots
- 65 years old or older: two shots, which will last you the rest of your life
- Between 2 and 64 years old: between one and three shots if you have certain immune system disorders or if youre a smoker
Questions To Ask Your Doctor
- When should I make an appointment to get each type of pneumococcal vaccine?
- Should I still get the vaccines if Ive recently had pneumonia?
- Should I wait to turn 65 before I get each dose of pneumococcal vaccines?
- If I have a negative reaction to one type of pneumococcal vaccine, am I likely to have that same reaction to the other?
Funding was provided for these pneumococcal resources through an unrestricted grant from Pfizer Independent Grant for Learning and Change .
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How Supplied/storage And Handling
Pneumovax 23 is supplied as follows:
NDC 0006-4943-00 a box of 10 single-dose vials, color coded with a purple cap and stripe on the vial labels and cartons.
NDC 0006-4837-03 a box of 10 single-dose, pre-filled Luer-Lok syringes with tip caps, color coded with a violet plunger rod and purple stripe on the syringe labels and cartons.
Storage and Handling
- Store at 2-8°C .
- All vaccine must be discarded after the expiration date.
The vial stoppers, syringe plunger stopper and syringe tip cap are not made with natural rubber latex.
Babies And The Pneumococcal Vaccine
Babies are routinely vaccinated with a type of pneumococcal vaccine known as the pneumococcal conjugate vaccine as part of their childhood vaccination programme.
Babies born on or after 1 January 2020 have 2 injections, which are usually given at:
- 12 weeks old
- 1 year old
Babies born before this date will continue to be offered 3 doses, at 8 and 16 weeks and a booster at 1 year.
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When To Get The Vaccine
Thereâs no such thing as pneumonia season, like flu season. If you and your doctor decide that you need to have a pneumonia vaccine, you can get it done at any time of the year. If itâs flu season, you can even get a pneumonia vaccine at the same time that you get a flu vaccine, as long as you receive each shot in a different arm.
How Many Doses Of The Pneumococcal Vaccine Do I Need
Most adults only need the vaccine once. But your doctor may recommend you get another shot if its been a while since you have the vaccine or for other reasons. Ask your doctor how often you need the shot.
You do not have to get the pneumococcal vaccine every year, like the flu shot. You may only need to get it once and a booster shot a few years later. Find out what your doctor recommends.
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Who Should Not Get These Vaccines
Because of age or health conditions, some people should not get certain vaccines or should wait before getting them. Read the guidelines below specific to pneumococcal vaccines and ask your or your childs doctor for more information.
Children younger than 2 years old should not get PPSV23. In addition, tell the person who is giving you or your child a pneumococcal conjugate vaccine if:
You or your child have had a life-threatening allergic reaction or have a severe allergy.
- Anyone who has had a life-threatening allergic reaction to any of the following should not get PCV13:
- A shot of this vaccine
- An earlier pneumococcal conjugate vaccine called PCV7
- Any vaccine containing diphtheria toxoid
You or your child are not feeling well.
- People who have a mild illness, such as a cold, can probably get vaccinated. People who have a more serious illness should probably wait until they recover. Your or your childs doctor can advise you.
How The Pneumococcal Vaccine Works
Both types of pneumococcal vaccine encourage your body to produce antibodies against pneumococcal bacteria.
Antibodies are proteins produced by the body to neutralise or destroy disease-carrying organisms and toxins.
They protect you from becoming ill if you’re infected with the bacteria.
More than 90 different strains of the pneumococcal bacterium have been identified, although most of these strains do not cause serious infections.
The childhood vaccine protects against 13 strains of the pneumococcal bacterium, while the adult vaccine protects against 23 strains.
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Recommendations For Pneumococcal Conjugate Vaccines In India
The burden of pneumococcal disease is the greatest among the underprivileged children in India. The PCVs are thus of public health importance and ideally should be available to all children. However the high cost of PCVs and the limited coverage of the currently available vaccine are impediments. GAVI has offered to supply PCV at a cost of 0.150.3 USD/dose to India for inclusion in the national immunization schedule and commits to extending this support until the year 2015. The risk of invasive pneumococcal disease is significantly lower in healthy children above the age of 2 y and thus benefit achieved with vaccination of these children is likely to be lower. Vaccination with single dose of PCV vaccine may be considered in children aged 25 y. Pneumococcal vaccination in not recommended in children aged 5 and above. The recommended dosage for PCV 13 is 0.5mL, and the vaccination route is intramuscular.
My Doctor Didnt Tell Me About The Vaccination Is It New
The CDC began recommending adults with asthma get the pneumococcal vaccination in 2008. In 2012, the CDC started recommending adults with certain medical conditions or who take medicines like corticosteroids get the second vaccine. If your doctor hasnt mentioned the vaccine, ask about it as soon as possible.
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The Different Types Of Pneumococcal Vaccine
The type of pneumococcal vaccine you’re given depends on your age and health. There are 2 types.
Pneumococcal conjugate vaccine is used to vaccinate children under 2 years old as part of the NHS vaccination schedule. It’s known by the brand name Prevenar 13.
Children at risk of pneumococcal infections can have the PPV vaccine from the age of 2 years onwards. The PPV vaccine is not very effective in children under the age of 2.
Who Should Not Get The Pneumonia Vaccine
Again, its best to determine this with your doctor, but as a general rule the CDC states you should not get the pneumococcal vaccine if:
- You or your child has had a severe or life-threatening allergy to the current PCV13 or Prevnar 13®) vaccine, the past PCV7 vaccine or any vaccine containing diphtheria toxoid.
- You or your child are currently battling a severe illness.
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Medical Conditions Resulting In High Risk Of Ipd
Table 1: Medical Conditions Resulting in High risk of IPD
IPD is more common in the winter and spring in temperate climates.
Spectrum of clinical illness
Although asymptomatic upper respiratory tract colonization is common, infection with S. pneumoniae may result in severe disease. IPD is a severe form of infection that occurs when S. pneumoniae invades normally sterile sites, such as the bloodstream or central nervous system. Bacteremia and meningitis are the most common manifestations of IPD in children 2 years of age and younger. Bacteremic pneumococcal pneumonia is the most common presentation among adults and is a common complication following influenza. The case fatality rate of bacteremic pneumococcal pneumonia is 5% to 7% and is higher among elderly persons. Bacterial spread within the respiratory tract may result in AOM, sinusitis or recurrent bronchitis.
Worldwide, pneumococcal disease is a major cause of morbidity and mortality. The World Health Organization estimates that almost 500,000 deaths among children aged less than 5 years are attributable to pneumococcal disease each year. In Canada, IPD is most common among the very young and adults over 65 years of age.
Persons With Chronic Diseases
Refer to Immunization of Persons with Chronic Diseases in Part 3 for additional information about vaccination of people with chronic diseases.
Asplenia or hyposplenia
Hyposplenic or asplenic individuals should receive Pneu-C-13 vaccine and Pneu-P-23 vaccine, followed by a booster dose of Pneu-P-23 vaccine. Refer to Table 3, Table 4 and Booster doses and re-immunization for additional information.
Chronic kidney disease and patients on dialysis
Individuals with chronic kidney disease should receive age appropriate pneumococcal vaccines. Children less than 18 years of age with chronic kidney failure or nephrotic syndrome, should receive Pneu-C-13 vaccine and Pneu-P-23 vaccine. Adults with chronic kidney failure should receive Pneu-P-23 vaccine. Adults with nephrotic syndrome should receive Pneu-C-13 and Pneu-P-23 vaccine. Due to the decreased immunogenicity and efficacy of Pneu-P-23 vaccine in children and adults with chronic kidney failure, 1 booster dose of Pneu-P-23 vaccine is recommended. Refer to Table 3, Table 4 and Booster doses and re-immunization for additional information.
Chronic lung disease, including asthma
Chronic heart disease
Chronic liver disease
Endocrine and metabolic diseases
Non-malignant hematologic disorders
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What Are The Possible Side Effects Of Pcv And Ppsv Vaccines
Kids may have redness, tenderness, or swelling where the shot was given. A child also might have a fever after getting the shot. There is a very small chance of an allergic reaction with any vaccine.
The pneumococcal vaccines contain only a small piece of the germ and so cannot cause pneumococcal disease.
Effect On Other Diseases And The Pharmacy Trade
There was a report on 3 March 2021, that social distancing and common wearing of surgical masks and similar as a common precaution against COVID-19 caused a drop in the spread rate of the common cold and flu. So much so, that in Britain the sale of cough liquids and throat lozenges and from 30 November 2020 to 21 February 2021, was about a half of the sale a year earlier. Public Health England reported no cases of flu in the year 2021 to date, and that there was an 89% rise in sales of Vitamin D to try to boost immunity.
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Children At High Risk Of Ipd
Infants at high risk of IPD due to an underlying medical condition should receive Pneu-C-13 vaccine in a 4 dose schedule at 2 months, 4 months and 6 months followed by a dose at 12 to 15 months of age. Table 3 summarizes the recommended schedules for Pneu-C-13 vaccine for infants and children at high risk of IPD due to an underlying medical condition by pneumococcal conjugate vaccination history.
In addition to Pneu-C-13 vaccine, children at high risk of IPD due to an underlying medical condition should receive 1 dose of Pneu-P-23 vaccine at 24 months of age, at least 8 weeks after Pneu-C-13 vaccine. If an older child or adolescent at high risk of IPD due to an underlying medical condition has not previously received Pneu-P-23 vaccine, 1 dose of Pneu-P-23 vaccine should be administered, at least 8 weeks after Pneu-C-13 vaccine. Children and adolescents at highest risk of IPD should receive 1 booster dose of Pneu-P-23 vaccine refer to Booster doses and re-immunization. Refer to Immunocompromised persons for information about immunization of HSCT recipients.
Table 3: Recommended Schedules for Pneu-C-13 Vaccine for Children 2 months to less than 18 years of age, by Pneumococcal Conjugate Vaccination History
|Age at presentation for immunization||Number of doses of Pneu-C-7, Pneu-C-10 or Pneu-C-13 previously received|
What Is A Pneumococcal Vaccine
A pneumococcal vaccine is an injection that can prevent pneumococcal disease. A pneumococcal disease is any illness that is caused by pneumococcal bacteria, including pneumonia. In fact, the most common cause of pneumonia is pneumococcal bacteria. This type of bacteria can also cause ear infections, sinus infections, and meningitis.
Adults age 65 or older are amongst the highest risk groups for getting pneumococcal disease.
To prevent pneumococcal disease, there are two types of pneumococcal vaccines: the pneumococcal polysaccharide vaccine and the pneumococcal conjugate vaccine .
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