Who should get a Pneumonia Vaccine?

Posted on Nov 2, 2012 in The Doctor Is In by Josh Allen

by Chris Prakash, MD

The flu season rolls around, and people know they need a flu shot. But there remains a lot of confusion on who should get a pneumonia shot. Pneumonia is the leading cause of vaccine-preventable death in the United States. An estimated 4000 deaths occur in the United States each year due to pneumococcus, with the vast majority occurring in adults and seniors.

Who should be getting the pneumonia vaccine, how often, is it safe; I will try to answer these questions.

Who is at Risk for pneumonia?:

• Anyone over 65 years old.
• Anyone with a suppressed immune system (patients with cancer or on chemotherapy).
• Children under 2 years old.
• Anyone with heart or lung disease.
• Anyone with alcoholism.
• Anyone with kidney failure.
• Anyone with HIV.
• Anyone with diabetes.

What is the Pneumonia Vaccine?:

The pneumonia vaccine for adults (Pneumovax) is a polysaccharide vaccine that protects against 23 types (strains) of pneumonia. Pneumonia as a disease has changed and evolved into a more resistant disease to antibiotics. That is why it is so important to be vaccinated against this very serious disease.

Usually, only one dose of the vaccine is necessary for adults. But sometimes you need a second dose:

• A person over age 65 who had their first dose before age 65 and more than 5 years have passed since they received the vaccine.
• Anyone without a spleen.
• Anyone with sickle cell disease or cancer.
• Anyone with HIV.
• Anyone with kidney failure or nephrotic syndrome.
• Anyone who has had an organ or bone marrow transplant.
• Anyone taking immuno-suppressing drugs (such as long-term steroids or chemotherapy).

Anyone under age 10 that needs a second dose, may receive it 3 years after the first dose. Anyone over age 10 that requires a second dose, may receive it 5 years after the first dose.

What are the Side Effects?

Side effects from the vaccine are generally very mild, and it is considered a very safe vaccine. Common side effects include:

• Pain or redness at the injection site
• Fever
• Muscle aches
• Very rarely, severe allergic reactions have been reported.

Is there a new pneumonia vaccine?

A new pneumococcal vaccine, 13-valent PCV13, has been in use in kids and adolescents since 2010. However, it has only recently been licensed for prevention of pneumococcal disease in adults. In June 2012, ACIP voted to recommend PCV13 for adults aged 19 or older with imunocompromising conditions, functional or anatomic asplenia, cerebrospinal fluid (CSF) leaks, or cochlear implants. However, PCV13 alone may not provide adequate coverage of disease-causing serotypes and, therefore, ACIP concluded that both PCV13 and PPSV23 should be recommended for adults with these high-risk conditions.

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This information is strictly an opinion of Dr Prakash, and is not intended to replace the advice of your doctor. Dr Chris Prakash is a contributing columnist, and author of eParisExtra’s “The Doctor is In” column. He is a medical oncologist at Texas Oncology Paris. He is board certified in Internal Medicine, Oncology and Hematology. He lives in Paris, TX with his wife and two children, and can be reached at 9037850031, or Sucharu.prakash@usoncology.com