Archive for the ‘pneumonia’ Category

Question About Newer Pneumococcal Vaccines

Q: In May of 2014, I was in the hospital for inguinal hernia repair and was offered the Pneumovax® 23, which I had been wanting for some time but none of my doctors would approve it. I did not ask for the Pneumovax® 23 at this time; it was offered to me and I accepted. I recently requested the Prevnar® 13, but my doctor denied it because I am not yet 65 (I understand the usual guidelines). I do have chronic health issues, which I believe would be an exception to the guidelines. What I don’t understand is, why give one without the other? Why be protected by 23 but not the additional 13?

The Pneumovax® 23 and Prevnar® 13 vaccines have 12 serotypes or variations, in common, which protect you against over the same 12 variations of the illness. Prevnar® 13 covers one more serotype, and Pneumovax® 23 covers 11 more serotypes. If you get immunized with Prevnar® 13 you are only getting 1 new serotype compared to the older vaccine.

What’s the main difference between the two vaccines? Although you don’t get as broad of coverage because of only 13 serotypes compared to 23 serotypes, the immune response from the Prevnar® 13 has been shown to be is a little bit better than with the Pneumovax® 23.

The Prevnar® 13 vaccine is recommended for all adults 65 years and older, but for younger adults ONLY IF you have a medical condition that causes you to be immunocompromised, such as removal of your spleen, HIV infection, organ transplant, chronic kidney failure, or long term use of immunosuppressive drugs like cortisone or Humira®. If you have one of those conditions, the Prevnar® 13 would give you a little better protection.

Since you received the Pneumovax® 23 before age 65, you should get another dose of it at or after age 65. However, for the best protection you should wait at least 11months or 1 year before getting the other pneumococcal vaccine. This means that if you get the Prevnar® 13 at age 65, you should wait a year before getting the Pneumovax® 23.

According to the Centers for Disease Control and Prevention (CDC), the maximum number of pneumococcal vaccines needed three: up to 2 doses of the older Pneumovax® 23 vaccine and only 1 dose of the Prevnar® 13. Most pharmacies carry both vaccines and can administer them to you. If your doctor declines to give you Prevnar®13, you have the option of going to your local pharmacy and having them give it to you.

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Another Pneumonia Shot

Q: What’s this about a new pneumonia shot? Do I need another one?

Probably. If you are 65 years old or older you should get two different “pneumonia shots” but you only have to get each of them once for lifelong protection. The vaccine that’s been used in infants is now recommended to be given to older adults in addition to the older adult formulation already being given.

Although many people call it a “pneumonia shot” it doesn’t really protect you against getting pneumonia. It really protects against infections caused by a particular bacteria. This bacteria has several names, including pneumococcus, Streptococcus pneumonia or S. pneumoniae. Pneumococcus can cause life-threatening infections of the lungs, the blood and the brain both in very young and in older people. Children younger than 2 years old and adults 65 years and older are most vulnerable to serious infection by pneumococcal bacteria.

Thousands of adults are hospitalized with life-threatening pneumonia caused by pneumococcal bacteria, and 18,000 adults age 65 and older die every year from pneumococcal infections. Pneumococcal bacteria can also cause an infection of the blood, called bacteremia and meningitis, which is infection of the lining of the brain.  According to the Centers for Disease Control and Prevention (CDC) based in Atlanta, pneumococcal bacteria are responsible for 1 out of every 5 cases of meningitis in the United States and are the most common cause of bacterial meningitis in children under 5 years of age.

Meningitis from infection with S. pneumonia is very difficult to treat with antibiotics. 40% of adults over the age of 65 who contract pneumococcal meningitis will die and those who survive are often left with permanent damage to their brain and nervous system. The CDC’s Active Bacterial Core Surveillance System documented 41,000 cases of serious pneumococcal disease with 4,900 deaths during 2006, and considers it one of the most preventable causes of death in the United States.

With more than 90 strains called serotypes of pneumococcal bacteria floating around, these vaccines protect us against the strains most responsible for severe infections by targeting a polysaccharide compound unique to each.

The CDC is now recommending giving Prevnar 13 vaccine to older adults as well as young children, for two reasons. Prevnar 13 will give protection against one  serotype that’s not included in the other one. It’s also made with an extra protein, added which acts to trigger a stronger immune response, making it more effective.

The CDC recommends all adults 65 years old and older receive BOTH pneumococcal vaccines, Prevnar 13 and Pneumovax 23. Most adults need only 1 shot of each in order to achieve lifetime immunity, but not at the same time. These vaccines should be given at least 1 year apart. Medicare will pay for each one.

Do you need the “new” pneumonia shot called Prevnar 13?

1.    YES, if you are over 65 years old and have never had a pneumococcal vaccine. The CDC recommends you get the other vaccine (Pneumovax 23) too, but one year later than your first one.

2.    YES, even if you’ve already had a shot of the Pneumovax 23, as long as it was at least a year ago. If you were younger than 65 years old when you got your first pneumococcal vaccine, you may eventually need another shot of Pneumovax 23, but you need to wait at least one year after getting vaccinated with Prevnar 13 and at least 5 years after a previous dose of Pneumovax 23.

3.    YES, if you are not yet 65 years old but have a medical condition that puts you at a higher risk of getting a serious infection. Your doctor can help you decide if you should get it.

4.    Possibly, if you are a healthy adult between 50 and 65 years old. Because one dose of Prevnar 13 will cost around $180, I suggest checking with your insurance first to see if they would pay for any of it before making a final decision.

Medicare will pay for both pneumococcal vaccines regardless of which one you get first, but ONLY if you get them at least 11 months apart. More information about the pneumococcal vaccines is available at

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