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How Often Should Pneumonia Vaccine Be Given

How Important Is It For An Adult Over Age 65 To Get Vaccinated

There’s a new pneumonia vaccine for adults

It’s very important. If you are over age 65 or have an underlying medical condition that puts you at risk and have not had a pneumococcal vaccination, talk to your doctor and ask to schedule one. According to the National Foundation for Infectious Disease, bacteremia and meningitis caused by invasive pneumococcal disease is responsible for the highest rates of death among the elderly and patients who have underlying medical conditions.

What Does The Pneumonia Vaccine Do

Pneumonia is a serious condition that attacks the lungs, causing coughing, fever, and difficulty breathing. It often requires hospitalisation, and can be life-threatening especially for the elderly or for people with weakened immune systems.

Pneumonia can be caused by viruses and fungi, but its usually caused by a bacterial infection. This is why both types of the pneumonia vaccine work by generating antibodies to kill pneumococcal bacteria. Once youve had the vaccine, your body will be able to use these antibodies to quickly fight off the bacteria strains that cause pneumonia.

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.

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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.

Who Else Should Get The Pneumococcal Vaccination

Pneumonia: Vaccine Given

For adults, the Centers for Disease Control and Prevention recommends pneumococcal vaccination for:

  • Anyone 65 years of age and older

  • Adults with any of these health conditions:

  • Chronic illnesses such as lung, heart, liver or kidney disease asthma diabetes or alcoholism

  • Conditions that weaken the immune system cochlear implants or cerebro-spinal fluid leaks asplenia

  • Adults who smoke cigarettes

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Do I Need To Pay For Pneumococcal Immunisation

Vaccines covered by the National Immunisation Program are free for people who are eligible. See the NIP Schedule to find out which vaccines you or your family are eligible to receive.

Eligible people get the vaccine for free, but your health care provider may charge a consultation fee for the visit. You can check this when you make your appointment.

If you are not eligible for free vaccine, you may need to pay for it. The cost depends on the type of vaccine, the formula and where you buy it from. Your immunisation provider can give you more information.

Immunisation Against Pneumococcal Disease For Babies And Children

The immunisation schedule for babies involves a course of a primary vaccine that reduces the risk of infection with 13 strains of pneumococcal bacteria.

A second type of vaccine that reduces the risk of infection with 23 strains of pneumococcal bacteria is given as a booster dose to children from four years of age if they:

  • have a medical condition putting them at high risk of pneumococcal disease, or
  • were born prematurely before 28 weeks gestation.

Protection for babies and children against pneumococcal disease is available under the National Immunisation Program Schedule. In Victoria, immunisation against pneumococcal disease is free of charge for:

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Side Effects Of The Pneumococcal Vaccine

Like most vaccines, the childhood and adult versions of the pneumococcal vaccine can sometimes cause mild side effects.

These include:

  • redness where the injection was given
  • hardness or swelling where the injection was given

There are no serious side effects listed for either the childhood or adult versions of the vaccine, apart from an extremely rare risk of a severe allergic reaction .

What Is A Pneumococcal Vaccine

Pneumonia Can Be PreventedVaccines Can Help Older Adults

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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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.

Neurologic disorders

Chronic lung disease, including asthma

Chronic heart disease

Chronic liver disease

Endocrine and metabolic diseases

Non-malignant hematologic disorders

Cochlear implants

Side Effects Of The Vaccines Against Pneumococcal Disease

Vaccines against pneumococcal disease are effective and safe, although all medications can have unwanted side effects.

Side effects from the vaccine are uncommon and usually mild, but may include:

  • localised pain, redness and swelling at the injection site
  • occasionally, an injection-site lump that may last many weeks
  • low-grade temperature .

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Patients In Health Care Institutions

Residents of long-term care facilities should receive Pneu-P-23 vaccine. Refer to Recommendations for Use for information about pneumococcal vaccination of individuals at increased risk of IPD. Refer to Immunization of Patients in Health Care Institutions in Part 3 for additional information about vaccination of patients in health care institutions.

Everything You Need To Know About The Pneumonia Vaccine

Recommended Adult Immunization Schedule

During the winter months, many people think that they have a nasty cold or flu, but it turns out to be pneumonia an illness that can be life threatening in certain people. A vaccine can help lower your chance of contracting pneumonia. While the pneumonia vaccine does not prevent all cases of pneumonia, it reduces the severity of the disease.

That is especially important for older adults and if you have certain medical conditions that put you at greater risk for complications.

Now is the time to talk to your doctor about your risks and if you need a vaccine to protect you against pneumonia.

Niharika Juwarkar, MD, Internal Medicine with Firelands Physician Group, answers your most frequently asked questions about pneumonia and the risks.

What is pneumonia?

Pneumonia is a respiratory lung infection that is often mistaken for the flu. Your lungs become filled with fluid or pus that results in inflammation. Symptoms are very similar to the flu, but pneumonia can last for weeks and result in very serious complications.

While pneumonia can be caused by bacteria, viruses or fungi, most cases are due to a specific bacteria called streptococcus pneumoniae, more commonly known as pneumococcal pneumonia. This form can be treated with antibiotics. Your doctor can test to see what form of pneumonia you have. Treatment depends on the type of pneumonia you have and the severity of your symptoms. But, the best defense is vaccination.

Who is most at risk for pneumonia?

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Who Needs A Pneumococcal Vaccination

The pneumococcal vaccine is available in Scotland for all people aged 65 years and over.

It may also be available if you’re under 65 and fall under one of the following risk groups, or have one of the following serious medical conditions:

  • problems with the spleen, either because the spleen has been removed or doesn’t work properly
  • chronic respiratory diseases, including chronic obstructive pulmonary disease , chronic bronchitis, and emphysema
  • serious heart conditions

Persons New To Canada

Health care providers who see persons newly arrived in Canada should review the immunization status and update immunization for these individuals, as necessary. Review of pneumococcal vaccination status is particularly important for persons from areas of the world where sickle cell disease is present, as persons with sickle cell disease are at risk of serious pneumococcal infections. In many countries outside of Canada, pneumococcal conjugate vaccine is in limited use. Refer to Immunization of Persons New to Canada in Part 3 for additional information about vaccination of people who are new to Canada.

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Common And Local Adverse Events

Pneumococcal conjugate vaccine

Studies of Pneu-C-13 vaccine indicated that irritability decreased appetite increased or decreased sleep and pain, swelling and redness at the injection site after the toddler dose and in older children, are common side effects. Low grade fever occurred in 20% to 30% or more of vaccine recipients. In adults over 50 years of age, the most commonly reported side effects included pain at the injection site, fatigue, headache and new onset of myalgia, with fever above 38°C occurring in approximately 3% of vaccine recipients.

Pneumococcal polysaccharide vaccine

Reactions to Pneu-P-23 vaccine are usually mild. Soreness, redness and swelling at the injection site occur in 30% to 60% of vaccine recipients and more commonly follow SC administration than IM administration. Occasionally, low grade fever may occur. Re-immunization of healthy adults less than 2 years after the initial dose is associated with increased injection site and systemic reactions. Studies have suggested that re-vaccination after an interval of at least 4 years is not associated with an increased incidence of adverse side effects. However, severe injection site reactions, including reports of injection site cellulitis and peripheral edema in the injected extremity, have been documented rarely with Pneu-P-23 vaccine in post-marketing surveillance, even with the first dose. Multiple re-vaccinations are not recommended refer to Booster doses and re-immunization.

Current Status Of The Vaccines

Dr. Cynthia G. Whitney – The pneumococcal vaccines

Although effective in relatively healthy individuals, many studies have shown that PPV23 is ineffective in reducing invasive pneumococcal disease in elderly and immunocompromised patients , including transplant patients and HIV-infected patients with low CD4+ cell counts .

Although designed for children, the serotypes found in PCV13 were responsible for half of invasive pneumococcal diseases in immunocompromised adults in 2010 . In the same year, less than one-fourth of invasive pneumococcal diseases were caused by serotypes found in PPV23 . Accordingly, in December 2011, the U.S. Food and Drug Administration licensed PCV13 for prevention of pneumonia and invasive pneumococcal disease in adults who are 50 years of age and older . Although PCV13 covers many serotypes that are prevalent in immunocompromised individuals, it does not cover several serotypes occurring in noncompromised patients , which raises a question about which vaccine physicians caring for adult patients should use.

According to latest CDC recommendations, patients with chronic liver disease, cirrhosis, alcoholism, and diabetes are at high risk for pneumococcal disease and require vaccination with PPV23. There is no current CDC recommendation on dual vaccination with PPV23 and PCV13. Further investigation is needed to better understand the most effective vaccine strategy in immunocompromised patients.

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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.

When To See A Doctor

A person who is over 65 years of age should talk to their doctor about which pneumonia vaccine may be best for them. The doctor can help determine whether they should get the vaccination, which vaccination to get, and when to get it.

Parents and caregivers of young children should talk to a pediatrician about the schedule for the pneumonia vaccination. The pediatrician can also address any questions or concerns about the safety and effectiveness of the vaccination.

A person does not need to see a doctor for mild reactions to the vaccine, such as tenderness at the injection site, fever, or fatigue.

However, if a person experiences any life threatening side effects, they should seek emergency help immediately.

Signs and symptoms of allergic reactions in children may include:

  • respiratory distress, such as wheezing

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How Often Should I Be Vaccinated

There are two types of pneumococcal vaccines available for adults: a pneumococcal polysaccharide vaccine and a pneumococcal conjugate vaccine . Adults with kidney disease, kidney failure, or a kidney transplant need to receive both vaccines.

Most healthy adults only need to be vaccinated one time, but some people at high risk, including people with kidney disease, dialysis-treated patients, and people with kidney transplants, need to receive two pneumococcal vaccines initially followed by revaccination in five years. Ask your doctor about your specific circumstances.

Effectiveness Of The Pneumococcal Vaccine

Preventing Whooping Cough (Pertussis)

Children respond very well to the pneumococcal vaccine.

The introduction of this vaccine into the NHS childhood vaccination schedule has resulted in a large reduction in pneumococcal disease.

The pneumococcal vaccine given to older children and adults is thought to be around 50 to 70% effective at preventing pneumococcal disease.

Both types of pneumococcal vaccine are inactivated or “killed” vaccines and do not contain any live organisms. They cannot cause the infections they protect against.

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How Often Is The Pneumococcal Vaccine Given

Babies receive the pneumococcal vaccine as three separate injections, at 2 months, 4 months and 12-13 months.

People over-65 only need a single pneumococcal vaccination which will protect for life. It is not given annually like the flu jab.

People with a long term health condition may need just a single one-off pneumococcal vaccination or five-yearly vaccination depending on their underlying health problem.

People With Medical Risk Factors

In addition to the 3 doses of 13vPCV routinely recommended for healthy non-Indigenous children < 5 years of age, children 12 months of age with risk conditions for pneumococcal disease are recommended to receive:

  • An additional dose of at 6 months of age
  • a dose of at 4 years of age
  • a 2nd dose of at least 5 years after the 1st dose of 23vPPV

This is because of the higher disease burden and the possibility of lower antibody responses in these children.2-4

Aboriginal and Torres Strait Islander children diagnosed with risk conditions at 12 months of age who live in the Northern Territory, Queensland, South Australia and Western Australia already receive these extra doses as part of their routine schedule.

Any child aged 6 to 11 months with a newly identified risk condition who has not received an additional dose of 13vPCV at 6 months of age should receive this dose at diagnosis. The exception is children who have received a haematopoietic stem cell transplant these children are recommended to receive 3 doses of 13vPCV after transplantation, followed by 2 doses of 23vPPV

All children and adults with newly identified risk conditions are recommended to receive:

  • 1 dose of at diagnosis (at least 2 months after any previous doses of 13vPCV
  • or at 4 years of age whichever is later
  • a 2nd dose of 23vPPV at least 5 years later

See also Vaccine information and Variations from product information for more details.

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Concerns About Immunisation Side Effects

If the side effect following immunisation is unexpected, persistent or severe or if you are worried about yourself or your childs condition after a vaccination, see your doctor or immunisation nurse as soon as possible or go directly to a hospital. Immunisation side effects may be reported to SAEFVIC, the Victorian vaccine safety service.

It is also important to seek medical advice if you are unwell, as this may be due to other illness rather than because of the vaccination.

How Often Do I Need To Get The Pneumonia Vaccine

What vaccinations are important for COPD patients?

The pneumonia vaccine also known as the pneumococcal vaccine offers protection against several strains of bacteria that can cause pneumonia. There are two types of the vaccine, one of which is specifically designed for adults over the age of 65 and anyone particularly high-risk because of a long-term health condition. The other vaccine Prevnar 13 is available in our stores for adults aged 18 and over.*

Most adults getting the pneumonia vaccine will only need to get it once. Others who are high risk may need to get booster jabs every few years.

If youve never had the pneumonia vaccine, and you think you could benefit, you should check to see if youre eligible for it on the NHS. If not, you can book yours with us and have it in your local LloydsPharmacy.

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