How Does The Pneumonia Vaccine Work
There are currently two vaccines administered in the United States:
Pneumococcal Disease And Adults
Pneumococcal disease is a serious infection that causes pneumonia, meningitis, and blood infection, as well as other less severe illnesses.
Pneumococcal pneumonia hospitalizes about 150,000 people in the US each year, killing about 5 percent-7 percent, or between 7,500 and 10,500 of them. The death rate is even higher among adults age 65 years and older and people with underlying health conditions.
Fewer adults get pneumococcal meningitis or bloodstream infection, but the mortality rate for these infections is higher, even with proper treatment. Pneumococcal meningitis kills about 1 in 6 older patients and blood infection kills about 1 in 8 adults who have these diseases. More than 3,000 US adults die each year from these forms of pneumococcal disease. Pneumococcal meningitis and bacteremia can also result in lifelong disability including deafness, brain damage, and limb amputation.
Adults of all ages are at increased risk for pneumococcal disease if they have any of the following conditions or risk factors:
- Chronic conditions such as heart disease, lung disease, diabetes, kidney disease, or liver disease
- Conditions that weaken the immune system, such as sickle cell disease, HIV/AIDS, cancer, or a damaged or missing spleen
- Cochlear implants or cerebrospinal fluid leaks
Whats The Difference Between Pcv13 And Ppsv23
|helps protect you against 13 different strains of pneumococcal bacteria||helps protect you against 23 different strains of pneumococcal bacteria|
|usually given four separate times to children under two||generally given once to anyone over 64|
|generally given only once to adults older than 64 or adults older than 19 if they have an immune condition||given to anyone over 19 who regularly smokes nicotine products like cigarettes or cigars|
- Both vaccines help prevent pneumococcal complications like bacteremia and meningitis.
- Youll need more than one pneumonia shot during your lifetime. A 2016 study found that, if youre over 64, receiving both the PCV13 shot and the PPSV23 shot provide the best protection against all the strains of bacteria that cause pneumonia.
- Dont get the shots too close together. Youll need to wait about a year in between each shot.
- Check with your doctor to make sure youre not allergic to any of the ingredients used to make these vaccines before getting either shot.
- a vaccine made with diphtheria toxoid
- another version of the shot called PCV7
- any previous injections of a pneumonia shot
- are allergic to any ingredients in the shot
- have had severe allergies to a PPSV23 shot in the past
- are very sick
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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.
What Is Pneumococcal Bacterial
Pneumococcal infection is caused by pneumococcal bacteria. It can cause serious illnesses, such as pneumonia, bacterial meningitis, and other conditions such as severe ear infections.
Some adults carry pneumococcal bacteria in the back of their nose and throat and can pass them around by coughing, sneezing, and close contact. Usually, this doesnt result in serious illness but it can lead to pneumococcal infection, including pneumococcal meningitis.
People aged 65 or over, and adults with certain health conditions, have a higher chance of becoming unwell with pneumococcal infection. People aged 65 or over are more likely to suffer serious long-term health problems from pneumococcal infection, and can even die.
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Who Is At Risk Of Pneumococcal
Adults at Risk for Pneumococcal DiseaseAdults 65 years or older are at increased risk for pneumococcal disease. Adults of all ages are also at increased risk for pneumococcal disease if they have: Sickle cell disease, no spleen, HIV infection, cancer, or another condition that weakens the immune system.
Adverse Reactions And Contraindications
The most common adverse reaction to PPSV23 and PSV13 is noted to be pain or tenderness at site of injection in approximately 60% of patients, progressing to swelling or induration in 20%.
Severe allergic reactions to PPSV23 and PSV13 are contraindication to both the vaccines, whereas a severe allergic reaction to any diphtheria toxoid-containing vaccine is a contraindication for PSV13 only.
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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.
Who Should Not Get The Pneumococcal Vaccine Or Should Wait To Get It
- You should not get the vaccine if you have had an allergic reaction to it or to a vaccine for diphtheria, such as DTaP, Tdap, or Td. Tell your healthcare provider if you had an allergic reaction to any other vaccine. Also tell your provider if you have any severe allergies.
- You should wait to get the vaccine if you are sick or have a fever.
- You may need to wait to get the vaccine if you are a pregnant woman. If possible, get the vaccine before you become pregnant. Talk to your healthcare provider about the risks of this vaccine. Your provider can tell you if you are at high risk for pneumococcal infection and when to get the vaccine if you are already pregnant.
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Pneumococcal Vaccine In Older Adults: A Primary Care Approach To Increasing Uptake
Pneumonia in older adults remains a leading cause ofmorbidity, mortality, and increased healthcarecosts. Streptococcus pneumoniae is a bacteriumknown to cause an array of illnesses in older adults, including pneumonia,meningitis, and bloodstream infections.1 Community-acquiredpneumonia is most commonly linked to Spneumoniae,and is associated with significant economic burden,hospitalization, and mortality rates.2,3Approximately 5.6 million cases of CAP occur in the United States annually of those cases, roughly 1.3 million lead to hospitalization.3 Themean age for CAP is 62.6 years, with direct costs exceeding$17 billion annually in the United States.3
In 2016,the Centers for Disease Control and Prevention reported influenza/pneumoniaas the eighth leading cause of death in those aged 65 years and older.4 Althoughpneumonia is considered a vaccine-preventable disease, the annual incidence ofthe disease remains high in the United States because of low vaccination rates.In 2016, thenational pneumococcal vaccination rate for individuals aged 65 years and olderwas 66.9%,far under the goal of 90% set by Healthy People 2020.5,6
What Vaccines AreAvailable, and How Effective Are They?
Who ShouldReceive the Vaccine and When?
Table. Time of Pneumococcal Vaccine Based on History in Adults Aged â¥65 Years10
What Barriers AffectVaccination Uptake in Primary Care?
How Can PCPsOvercome Barriers?
Who Should Have The Pneumococcal Vaccine
Anyone can get a pneumococcal infection. But some people are at higher risk of serious illness, so it’s recommended they’re given the pneumococcal vaccination on the NHS.
- adults aged 65 or over
- children and adults with certain long-term health conditions, such as a serious heart or kidney condition
Babies are offered 2 doses of pneumococcal vaccine, at 12 weeks and at 1 year of age.
People aged 65 and over only need a single pneumococcal vaccination. This vaccine is not given annually like the flu jab.
If you have a long-term health condition you may only need a single, one-off pneumococcal vaccination, or a vaccination every 5 years, depending on your underlying health problem.
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Are There Side Effects
Some people have side effects from the vaccine, but these are usually minor and last only a short time. It is quite common to have some swelling and soreness in the arm where the needle was given. Occasionally slight fever may occur. Other side effects – such as headache, a higher fever or fatigue may occur, but these are rare. You should always discuss the benefits and risks of any vaccine with your doctor.
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.
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Adults At High Risk Of Ipd
Adults with immunocompromising conditions resulting in high risk of IPD, except HSCT, should receive 1 dose of Pneu-C-13 vaccine followed at least 8 weeks later by 1 dose of Pneu-P-23 vaccine, if not previously received. The dose of Pneu-C-13 vaccine should be administered at least 1 year after any previous dose of Pneu-P-23 vaccine. Refer to Immunocompromised persons for information about immunization of HSCT recipients.
Immunocompetent adults with conditions or lifestyle factors resulting in high risk of IPD should receive 1 dose of Pneu-P-23 vaccine, if not previously received. One dose of Pneu-P-23 vaccine is also recommended for all adults who are residents of long-term care facilities and should be considered for individuals who use illicit drugs.
Some experts also suggest a dose of Pneu-C-13 vaccine, followed by Pneu-P-23 vaccine, for immunocompetent adults with conditions resulting in high risk of IPD as this may theoretically improve antibody response and immunologic memory. However, Pneu-P-23 vaccine is the vaccine of choice for these individuals, and if only one vaccine can be provided, it should be Pneu-P-23 vaccine, because of the greater number of serotypes included in the vaccine.
Adults at highest risk of IPD should also receive 1 booster dose of Pneu-P-23 vaccine refer to Booster doses and re-immunization.
Table 4 – provides recommended schedules for adult immunization with pneumococcal vaccines.
Side Effects Of The Pneumococcal Vaccine
Like most vaccines, the childhood and adult versions of the pneumococcal vaccine can sometimes cause mild side effects.
- 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 .
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How The Vaccine Is Given
- Before you are given the vaccine, ask to read the manufacturer’s printed information leaflet. The manufacturer’s leaflet will give you more information about the vaccine and will tell you about any side-effects which you may experience from having it. If you have any questions about the vaccine, ask your doctor or nurse for advice.
- You will be given one dose of the vaccine. It may be given at the same time as some other vaccines, such as the flu vaccine, but it will be given as a separate injection.
- Most adults over 65 will be given a single, one-off dose of pneumococcal vaccine. Some people with kidney problems or immune system problems may need a ‘booster’ dose every five years. Your doctor will advise you on this.
- The vaccine is given by injection into a muscle, or as an injection underneath your skin.
Who Received Pneumococcal Conjugate Vaccine
Pneumococcal conjugate vaccine protects against 13 types of pneumococcal bacteria. PCV13 is routinely given to children at 2, 4, 6, and 1215 months of age. It is also recommended for children and adults 2 to 64 years of age with certain health conditions, and for all adults 65 years of age and older.
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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.
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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How Do We Know The Vaccine Is Safe
All medicines are tested for safety and effectiveness by the Medicines and Healthcare Products Regulatory Agency . The vaccine meets the high safety standards required for it to be used in the UK and other European countries. The vaccine has been given to millions of people worldwide.
Once they’re in use, the safety of vaccines continues to be monitored by the MHRA.
What To Think About
Medicines, such as penicillin, used to work well for the treatment of pneumonia and meningitis. These diseases have recently become resistant to these medicines. For this reason it is important to try to prevent the infections by having the PCV or PPV vaccine.
PCV can prevent some ear infections. But ear infections have many causes and PCV only works to prevent some of them. Your child may still have ear infections, even after getting a PCV shot.
PPV has not been studied in pregnant women. There is no evidence that the vaccine is harmful to either the mother or the baby. Pregnant women should talk with a doctor about getting the medicine. Women who are at high risk of pneumococcal disease should have the shot before becoming pregnant, if possible.
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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.
Do You Need Both Prevnar 13 And Pneumovax 23
ACIP now recommends that patients have a conversation with their doctor to decide whether to get Prevnar 13. However, older adults who have a high risk for pneumococcal disease should still receive both Prevnar 13 and Pneumovax 23. Additionally, Pneumovax 23 is still recommended for all adults over age 65.
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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.