Recommendations For Adults With Previous Ppsv23 Vaccinations
Adults 65 years of age or older who do not have an immunocompromising condition, cochlear implant, or cerebrospinal fluid leak and who have not previously received PCV13 may receive a dose of PCV13. Based on , clinicians and these older adults can discuss PCV13 vaccination to decide if it is appropriate. For those who choose to receive PCV13, give the dose of PCV13 at least 1 year after the most recent PPSV23 dose. Additionally, all adults 65 years or older should receive 1 dose of PPSV23 after age 65 years old regardless of their previous PPSV23 vaccination history. Doses of PPSV23 should be spaced 5 years apart from each other.
Adults 19 years of age or older who previously received one or more doses of PPSV23 should receive a dose of PCV13 at least one year after administration of the most recent PPSV23 dose if they have
- Immunocompromising conditions
- CSF leaks
- Cochlear implants
For those who require an additional dose of PPSV23, administer it no sooner than 8 weeks after PCV13 and at least 5 years after the most recent dose of PPSV23.
Pneumococcal Vaccine Timing for Adults pdf icon provides a summary of this detailed guidance.
What Is Pneumococcal Disease
This contagious disease is caused by pneumococcal bacteria , which is the root concern behind many mild to severe respiratory infections. Pneumococcal bacteria can spread from person to person easily via respiratory droplets shared by coughing, sneezing, or close contact to an infected individual or surface. This disease typically starts as a mild infection in the nose, throat, ears, and sinusesbecoming extreme once it spreads to other parts of the body. In severe cases, an individual can develop pneumonia, bacteremia, and meningitiswhich can lead to complications and disabilities .
How Many Doses Of Ppsv23 Can An Adult Get In A Lifetime Who/when
CDC recommends some adults receive up to 3 doses of PPSV23 in a lifetime. Adults who have immunocompromising conditions should receive two doses of PPSV23, given 5 years apart, before age 65 years. Those adults should then receive a third dose of PPSV23 at or after 65 years, as long as its been at least 5 years since the most recent dose.
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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.
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
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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Vaccines For Adults And Seniors
The National Immunisation Program schedule provides free vaccinations for adults and seniors. You may need booster doses of some vaccines to maintain high levels of protection. Most vaccines are more effective if delivered at a specific age.
The following vaccines are provided free to adults and seniors aged 65 years and over:
How Did Cdc Make The Decision To Recommend Pcv13 For Adults
CDC sets the adult immunization schedule based on recommendations from the Advisory Committee on Immunization Practices . ACIP used the Grading of Recommendations, Assessment, Development, and Evaluation approach or Evidence to Recommendations framework to evaluate evidence for PCV13 vaccination recommendations:
When To Get The Vaccine & What To Expect
Of course, before seeking the pneumococcal vaccines, its important to first speak with your primary care physician and other providers in your healthcare network. Both vaccines are safe but can have side effects and should be avoided by individuals with allergic reactions to any of the components in the vaccine. Keep in mind, its recommended that you not receive both vaccines at the same time. Talk to your healthcare provider to determine if both vaccinations are the right choice for your needs. If both vaccines are needed, PCV13 should be given prior to PPSV23. Its important to schedule a separate visitation at least one year after the professionally suggested PCV13 vaccination to receive a dose of the PPSV23 vaccine.
Booster Doses Of Pneumococcal Vaccine
If you’re at increased risk of a pneumococcal infection, you’ll be given a single dose of the PPV vaccine.
But if your spleen does not work properly or you have a chronic kidney condition, you may need booster doses of PPV every 5 years.
This is because your levels of antibodies against the infection decrease over time.
Your GP surgery will advise you on whether you’ll need a booster dose.
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Who Needs The Pneumococcal Vaccine
The Centers for Disease Control and Prevention recommends the PPSV23 vaccine for all adults 65 years or older as well as adults 19 years or older with certain medical conditions that could put them at greater risk of infection. The PCV13 vaccine, on the other hand, should be a shared decision between the patient and clinician due to additional medical considerations.
Tdap Vaccine And/or The Td Booster
Who needs it: The Tdap vaccine came out in 2005, and along with protecting against tetanus and diphtheria, like the vaccine it replaced, it also includes new, additional protection against whooping cough, also known as pertussis. If you cant remember ever getting this shot, you probably need it. And doing so, says Katz, can also count for one of the Td boosters youre supposed to get every 10 years.
How often: You get Tdap only once, and after that, you still need the Td booster every 10 years. Otherwise, your protection against tetanus and diphtheria will fade.
Why you need it: Due to a rise in whooping cough cases in the U.S., you really do need to be vaccinated against it, even if youre over 65. In the first year after getting vaccinated, Tdap prevents the illness in about 7 out of 10 people who received the vaccine.
Talk to your doctor if you: Have epilepsy or other nervous system problems, had severe swelling or pain after a previous dose of either vaccine, or have Guillain-Barré syndrome.
Parting shot: This vaccine is especially crucial for people who have close contact with infants younger than 12 months of age including parents, grandparents, and child care providers.
Shingles Vaccine For Older Adults
Shingles is caused by the same virus as chickenpox. If you had chickenpox, the virus is still in your body. The virus could become active again and cause shingles.
Shingles affects the nerves. Common symptoms include burning, shooting pain, tingling, and/or itching, as well as a rash with fluid-filled blisters. Even when the rash disappears, the pain can remain. This is called post-herpetic neuralgia, or PHN.
The shingles vaccine is safe and it may keep you from getting shingles and PHN. Healthy adults age 50 and older should get vaccinated with the shingles vaccine, which is given in two doses.
You should get a shingles shot even if you have already had chickenpox, the chickenpox vaccine, or shingles, received Zostavax, or dont remember having had chickenpox. However, you should not get a vaccine if you currently have shingles, are sick or have a fever, have a weakened immune system, or have had an allergic reaction to Shingrix. Check with your doctor if you are not sure what to do.
You can get the shingles vaccine at your doctors office and at some pharmacies. Medicare Part D and private health insurance plans may cover some or all of the cost. Check with Medicare or your health plan to find out if it is covered.
What Does Shared Clinical Decision
- PCV13 is a safe and effective vaccine for older adults. The risk for PCV13-type disease among adults aged 65 years is much lower than it was before the pediatric program was implemented, as a result of indirect PCV13 effects . The remaining risk is a function of each individual patients risk of exposure to PCV13 serotypes and the influence of underlying medical conditions on the patients risk of developing pneumococcal disease if exposure occurs.
- The following adults aged 65 years are potentially at increased risk of exposure to PCV13 serotypes and might attain higher than average benefit from PCV13 vaccination, and providers/practices caring for many patients in these groups may consider regularly offering PCV13 to their patients aged 65 years who have not previously received PCV13:
- Persons residing in nursing homes or other long-term care facilities
- Persons residing in settings with low pediatric PCV13 uptake
- Persons traveling to settings with no pediatric PCV13 program
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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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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.
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 Often Do I Need To Get The Pneumonia Vaccine
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.
Does The Pneumonia Vaccine Stop You Getting Pneumonia
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.
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Does Medicare Cover Vaccines For Older Adults
Medicare Part B covers vaccines that protect against the flu and pneumococcal disease and the hepatitis B vaccine if youre at increased risk for hepatitis B. It also covers vaccines that you might need after an injury or coming into contact with a disease .
Medicare Part D plans generally cover more vaccines than Part B. But depending on your Medicare Part D plan, you may have out-of-pocket costs for these vaccines. Contact Medicare to find out whats covered.
Did you know? There is a high-dose flu vaccine and an adjuvanted flu vaccine, which includes an adjuvant that creates a stronger immune response. Both vaccines are designed to be more effective in older adults. Learn more about flu vaccines for adults age 65 and older .
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.
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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.
- 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 .