Monday, September 26, 2022

Pneumonia Vaccine Adults How Often

How Do We Know The Vaccine Is Safe

There’s a new pneumonia vaccine for adults

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.

Medical Conditions Resulting In High Risk Of Ipd

Table 1: Medical Conditions Resulting in High risk of IPD

Non-immunocompromising conditions

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.

Disease distribution

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.

Who Should Not Get The Vaccine

People should not get the vaccine if they have had a life threatening allergic reaction to a previous dose.

Additionally, a person should not undergo vaccination if they have had an allergic reaction to medication containing diphtheria toxoid or an earlier form of the pneumonia vaccination .

Lastly, people who are sick or have allergic reactions to any of the ingredients of the vaccine should talk to a doctor before getting the shot.

A pneumonia shot will not reduce pneumonia. However, it helps prevent invasive pneumococcal diseases, such as meningitis, endocarditis, empyema, and bacteremia, which is when bacteria enter the bloodstream.

Noninvasive pneumococcal disease includes sinusitis.

There are two types of pneumonia shots available. Which type a person gets depends on their age, whether or not they smoke, and the presence of any underlying medical conditions.

The two types are:

  • Pneumococcal conjugate vaccine : Healthcare providers recommend this vaccine for young children, people with certain underlying conditions, and some people over the age of 65 years.
  • Pneumococcal polysaccharide vaccine : Healthcare providers recommend this vaccine for anyone over 65 years of age, people with certain underlying conditions, and people who smoke.

According to the

  • roughly 8 in 10 babies from invasive pneumococcal disease
  • 45 in 100 adults 65 years or older against pneumococcal pneumonia
  • 75 in 100 adults 65 years or older against invasive pneumococcal disease

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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:

The Pneumonia Vaccine Explained

Pneumonia

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.

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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.

How Many Doses Of Pcv13 Can An Adult Get In A Lifetime Who/when

CDC recommends adults receive 1 dose of PCV13, if indicated and if they have not received PCV13 previously . In addition, adults age 65 or older who do not have an immunocompromising condition, cerebrospinal fluid leak, or cochlear implant can choose to receive PCV13 based on shared clinical decision-making. However, if an adult received a dose of PCV13 prior to turning 65 years of age , they should not receive a dose of PCV13 when they turn 65.

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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

Whats The Difference Between Pcv13 And Ppsv23

ASK UNMC What is the new recommendation on pneumonia vaccines for older adults?
PCV13
helps protect you against 13 different strains of pneumococcal bacteriahelps protect you against 23 different strains of pneumococcal bacteria
usually given four separate times to children under twogenerally 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 conditiongiven 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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Babies And The Pneumococcal Vaccine

Babies are routinely vaccinated with a type of pneumococcal vaccine known as the pneumococcal conjugate vaccine as part of their childhood vaccination programme.

Babies born on or after 1 January 2020 have 2 injections, which are usually given at:

  • 12 weeks old
  • 1 year old

Babies born before this date will continue to be offered 3 doses, at 8 and 16 weeks and a booster at 1 year.

Two Inactivated But Nonequivalent Vaccines

Irrespective of some shared serotypes, PPSV23 and PCV13 also differ in their abilities to generate an effective immune response. Both polysaccharide vaccines generate antibodies against pneumococcal capsular antigens in a T-independent and B-cell-mediated fashion, but only PCV13 can induce a T-cell-dependent response. PCV13, unlike PPSV23, contains a protein conjugate, allowing for a more robust immunogenicity with enhanced avidity and memory for pneumococcal polysaccharide antibodies. Covalent attachment of this nontoxic protein conjugates to the vaccine also allows B-cells to produce antibodies in sufficient amounts to control infection and even reduce or suppress nasopharyngeal colonization with certain vaccine serotypes. Even more, unvaccinated adults have also shown comparable reductions in colonization, suggesting an indirect protection from conjugate vaccines through mechanisms also seen in herd immunization.

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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.

Persons With Inadequate Immunization Records

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Children and adults lacking adequate documentation of immunization should be considered unimmunized and should be started on an immunization schedule appropriate for their age and risk factors. Pneumococcal vaccines may be given, regardless of possible previous receipt of the vaccines, as adverse events associated with repeated immunization have not been demonstrated. Refer to Immunization of Persons with Inadequate Immunization Records in Part 3 for additional information about vaccination of people with inadequate immunization records.

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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.

Concurrent Administration Of Vaccines

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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Extended Pneumococcal Immunisation For High

As part of the extended immunisation programme for high-risk groups, PCV13 and 23PPV are funded for eligible individuals, as shown in Table 16.3, Table 16.4 and Table 16.5. Because the recommended schedule depends on the age of the individual at diagnosis, the tables have been organised into age groups .

The PCV13 and 23PPV funding restrictions are as follows. See Table 16.3, Table 16.4 and Table 16.5 for the eligible conditions and dosing requirements.

PCV13

All high-risk infants are recommended to receive at least three doses of a PCV vaccine, with at least one dose after 12 months of age. Change from PCV10 to PCV13 as soon as the infant is diagnosed as being at high risk.

  • Two doses of PCV13 are funded for high-risk children aged from 12 months and under 18 years who have previously received two or three doses of PCV10.
  • Up to four doses of PCV13 are funded for vaccination or re-vaccination of high-risk children aged under 5 years.
  • Up to four doses of PCV13 are funded for vaccination or re-vaccination of eligible individuals aged 5 years and older.

23PPV

1 dose of PCV13.b

23PPV

Give a maximum of 3 doses of 23PPV in a lifetime, a minimum of 5 years apart. The first 23PPV dose is given at least 8 weeks after PCV13, the 2nd a minimum of 5 years later, and the 3rd dose at age 65 years.

  • PCV13 is funded pre- or post-HSCT or chemotherapy. 23PPV is only funded post-HSCT or chemotherapy.
  • Children At High Risk Of Ipd

    Pneumonia Can Be PreventedVaccines Can Help Older Adults

    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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    If I Inadvertently Administer Ppsv23 Less Than 8 Weeks After Pcv13 Do I Need To Repeat The Dose Of Either Vaccine

    No, you do not need to repeat any doses. PPSV23 that follows PCV13 at less than 8 weeks may increase risk for localized reaction at the injection site, but remains a valid vaccination and you should not repeat it. The PCV13 dose also remains valid and you should not repeat it either. Never administer PPSV23 and PCV13 during the same visit.

    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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