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How Many Doses Of Pneumonia Vaccine

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Confused About the Pneumococcal Vaccine Schedule? You’re Not Alone | The Morning Report

Pneumococcal vaccines can protect you against getting pneumonia, which is contagious and spreads from close, person-to-person contact. Pneumonia is an infection of the lungs and can lead to many symptoms, including:

  • cough
  • chest pains
  • bringing up mucus when you cough

For seniors, pneumonia can be very serious and life-threatening. This is especially true if you have a chronic condition, such as diabetes or COPD. Pneumonia can also develop after youve had a case of the flu or a respiratory virus such as COVID-19. It is extremely important to stay current on flu shots each year in addition to your pneumococcal vaccines.

While PPSV23 and PCV13 do not protect against all types of pneumonia, they can make it less likely that you will experience severe and possibly life-threatening complications from the illness.

The American Academy of Family Physicians recommends that seniors who have not had either pneumococcal vaccine should get a dose of PCV13 first, and then a dose of PPSV23 6-12 months later. The vaccines cannot be given at the same time. If you have recently had a dose of PPSV23, your doctor will wait at least one year to give you PCV13.

How Often Do You Need To Get The Pneumonia Vaccines

Sometimes, vaccines require a booster shot. This means that an additional shot is given after the initial one to make sure that you dont lose immunity over time.

PCV13 never requires a booster shot in children or adults after all recommended doses are received.

Sometimes, PPSV23 requires a booster shot, depending on when and why it was given:

  • Children who get PPSV23 due to certain health conditions, like cancer and conditions that weaken the immune system, need a booster 5 years after the first dose.

  • Adults who get PPSV23 before age 65 should get one booster at least 5 years after the first dose, once theyve turned 65. No booster is needed if the first dose is given after age 65.

  • Adults with a weakened immune system and other specific conditions should have another dose 5 years after their first dose, and then one more dose at least 5 years after their most recent dose, once theyve turned 65.

Do The Pneumonia Vaccines Work

The pneumococcal vaccines are very effective at preventing pneumonia and other pneumococcal diseases in both adults and children. In one large study of over 84,000 adults aged 65 and older, those who received PCV13 were less likely to get pneumococcal pneumonia than were those who received a placebo shot. The vaccine protected about 45% of vaccinated people from getting pneumonia and about 75% from getting an invasive pneumococcal disease. Invasive pneumococcal disease is the most serious type and can be life-threatening.

PPSV23 is also effective and protects at least 50% of vaccinated, healthy adults from invasive pneumococcal infections.

In children, PCV13 has decreased the amount of invasive pneumococcal disease. According to the CDC, PCV13 prevented about 30,000 cases of invasive disease in the first 3 years it was available.

Getting the vaccine not only protects you from getting pneumonia and other types of pneumococcal disease, but also protects vulnerable people around you who cant get vaccinated.

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Effectiveness Of The Pneumococcal Vaccine

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.

Common And Local Adverse Events

Pneumococcal vaccination for all Australians

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.

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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 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.

These include:

  • babies
  • 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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Recommended But Not Funded

Risk stacking

Two classifications of IPD risk are recognised: high-risk conditions for which there is significant risk of IPD and atrisk conditions, which on their own may not significantly increase risk, but when combined together or with lifestyle risk factors increase an individuals risk of IPD. This is described as risk stacking IPD incidence substantially increases with the accumulation of concurrent risk factors or conditions. The risk of pneumococcal infections in those with two or more at-risk conditions may be as high as the risk for those with a recognised high-risk condition.

Recommendations

PCV13 and 23PPV are recommended but not funded for the following individuals:

  • immune-competent adults at increased risk of pneumococcal disease or its complications because of chronic illness
  • adults with cerebrospinal uid leak
  • immunocompromised adults at increased risk of pneumococcal disease
  • individuals of any age who have had one episode of IPD
  • smokers.

For those individuals who choose to purchase PCV13 and 23PPV vaccines, providers may follow the age-appropriate schedules in Table 16.4 and Table 16.5.

Adults aged 65 years and older with no other risk factors

Give one dose of PCV13 followed at least eight weeks later with 23PPV .

Concurrent Administration Of Vaccines

PCV13 for Immunocompromised Adults

Pneumococcal vaccines may be administered concomitantly with other vaccines, with the exception of a different formulation of pneumococcal vaccine . There should be at least an 8 week interval between a dose of pneumococcal conjugate vaccine and a subsequent dose of Pneu-P-23 vaccine, and at least a 1 year interval between a dose of Pneu-P-23 vaccine and a subsequent dose of pneumococcal conjugate vaccine refer to Immunocompromised persons for information regarding administration of pneumococcal vaccines to HSCT recipients. Different injection sites and separate needles and syringes must be used for concurrent parenteral injections. Refer to Timing of Vaccine Administration in Part 1 for additional information about concurrent administration of vaccines.

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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 .

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.

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The Pneumonia Vaccine Explained

While pneumonia is usually mild, it can have deadly consequences for portions of the population, especially people over the age of 65. In fact, Streptococcus pneumoniae, the bacteria that causes pneumococcal disease, is the No. 1 cause of pneumonia worldwide.

The vaccine indirectly protects adults by stopping children from spreading the bacteria

“But this bacteria doesn’t just cause pneumonia. It’s a nasty human pathogen that can invade the brain and bloodstream, leading to ear infections, sinus infections, even meningitis,” says Dr. Michael Ben-Aderet, associate medical director of Hospital Epidemiology at Cedars-Sinai.

“It can make people very sick, and it’s a key cause of death among the elderly.”

In 2017, an estimated 3,600 people died from invasive pneumococcal disease in the U.S. alone.

Concomitant Use Of Pneumovax 23 With Other Vaccines

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  • Limited safety and immunogenicity data from clinical trials are available on the concurrent administration of PNEUMOVAX 23 and vaccines other than ZOSTAVAX.
  • In a randomized clinical study, a reduced immune response to ZOSTAVAX® was observed in individuals who received concurrent administration of PNEUMOVAX 23 and ZOSTAVAX compared with individuals who received these vaccines 4 weeks apart. Consider administration of the 2 vaccines separated by at least 4 weeks.

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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 .

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 immunizationNumber of doses of Pneu-C-7, Pneu-C-10 or Pneu-C-13 previously received

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What Are The Side Effects Of The Pneumonia Vaccines

PCV13 and PPSV23 can both cause mild side effects. Both pneumococcal vaccines are given in the arm and are injected into muscle. Children and adults may experience arm soreness, swelling, or redness where the shot was injected. Other side effects that may occur in adults include:

  • Fatigue

  • Drowsiness

PCV13 should not be given to children at the same time as the annual flu shot, because of an increased risk of . These seizures are caused by a high fever and occur in up to 5% of children under 5. They can be scary, but dont cause any long-term health problems.

The good news is that the side effects will resolve on their own within a few days.

What Is Ppsv23

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PPSV23 protects against 23 types of bacteria that cause pneumococcal disease. It is recommended for all adults 65 and older. Anyone with certain medical conditions who is 2 years or older may also need the vaccine.

Most people only need one dose of PPSV23. But even if youve already had one dose before turning 65, you should get another dose of PPSV23 after you turn 65. Your doctor may also recommend that you get a dose of another type of pneumococcal vaccine, PCV13.

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Why It Is Used

Pneumococcus is a type of bacteria that can cause severe infections, such as pneumonia, meningitis, and blood infections . These infections can be serious and can even cause death, especially in people who have impaired immune systems, older adults, and children younger than 2 years of age.

Doctors use two types of pneumococcal vaccines for routine immunization: pneumococcal conjugate or pneumococcal polysaccharide . The type of vaccine used depends on a person’s age.

  • Pneumococcal conjugate
  • PCV is recommended for routine use in babies who get 3 or 4 doses depending on your provincial recommendations.
  • Children from 1 to 18 years old may be recommended to get an extra dose if they did not get all the doses as a baby. They may also need an extra dose if they have certain medical conditions that place them at high risk for infection with pneumococcus.
  • The vaccine may be recommended for adults at high risk for infection with pneumococcus. This recommendation depends on the medical condition the adult has and on provincial recommendations.
  • Pneumococcal polysaccharide for people at high risk
  • PPV is generally recommended for all people 65 and older and for those ages 2 to 64 who have a chronic disease or illness, an impaired immune system, or who live in areas or among social groups where there is an increased risk for pneumonia or meningitis.
  • Global Epidemiology Since The Introduction Of Pneumococcal Conjugate Vaccines

    Direct impact of PCV programmes on IPD in children

    Reductions in IPD among target cohorts of children in high income countries have been similar for PCV10 and PCV7/13 in reported studies. Québec and Finland both used 2+1 schedules and observed 83 percent and 79 percent reductions in IPD in vaccine-eligible children, respectively. In England, using PCV7 then PCV13 in a 2+1 schedule, there was an estimated 5,000 fewer hospital admissions for bacteraemia, meningitis and pneumonia in children aged under 5 years over 12 years after the introduction of PCV7 and PCV13. The greatest reductions were seen in meningitis in children under 2 years age.

    Direct impact of vaccination on non-invasive pneumococcal disease

    The impact of pneumococcal conjugate vaccination on the large burden of noninvasive pneumococcal disease has been clearly demonstrated internationally in countries that have introduced these vaccines, particularly through reductions in childhood hospitalisations due to pneumonia. Other impacts, such as on acute otitis media, are less clear and more difficult to measure accurately. However, a systematic review found PCVs were associated with large reductions in risk of pneumococcal acute otitis media, but there was no evidence of benefit against allcause otitis media in high-risk children over 1 year of age or older children with a history of respiratory illness.

    Herd immunity

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    What Are The Side Effects

    Vaccines are very safe. It is much safer to get the vaccine than to get pneumococcal disease.

    Many people have no side effects from the vaccines. For those that do, side effects are usually mild and last 1 to 2 days . Serious side effects are very rare.

    It is important to stay in the clinic for 15 minutes after getting any vaccine because there is a very rare possibility, between one in 100,000 and one in a million, of a life-threatening allergic reaction called anaphylaxis. This may include hives, difficulty breathing, or swelling of the throat, tongue or lips. Should this reaction occur, your health care provider is prepared to treat it. Emergency treatment includes injection of epinephrine and transfer by ambulance to the nearest emergency department. If symptoms develop after you leave the clinic, call 9-1-1 or the local emergency number.

    It is important to always report serious or unexpected reactions to your immunizing health care provider.

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