Posts Tagged ‘vaccine’

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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Not Just A Pneumonia Shot

December 14th, 2012. Filed Under: Immunization, Influenza.
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Q: I get a flu shot every year. Don’t I need a pneumonia shot, too?

What many people call the “pneumonia shot” is actually a vaccine that protects you from being infected by a particular type of bacteria instead of against a particular disease.

This bacteria has several names: pneumococcus, Streptococcus pneumonia and S. pneumoniae. The vaccine that protects against it is called pneumococcal vaccine, which is designed to protect you against life-threatening infections of the lungs (pneumonia), the blood and the brain (meningitis).

Amazingly, pneumococcus bacteria doesn’t ALWAYS cause serious infection. It’s not unusual to find it living in our nose or throat from time to time without causing any signs or symptoms of infection. Having bacteria living on our skin or inside our bodies without causing an infection is called colonization. The Centers for Disease Control (CDC) based in Atlanta estimates that up to 10% of all Americans are colonized with pneumococcus at any one time and most of us have been colonized with it at some point during the past year.

The most common infection caused by pneumococcus is a bacterial ear infection in children called otitis media. Before a vaccine became available in 1997, pneumococcus was responsible for 5 million cases of otitis media in children every year.

S. pneumoniae got its name from its ability to cause pneumonia, the most deadly complication of contracting influenza or “the flu”. Between 100,000 and 135,000 adults each year are hospitalized with life-threatening pneumonia caused by pneumococcal bacteria.

Other serious infections caused by pneumococcal infection include a blood infection called bacteremia and meningitis, infection of the lining of the brain.  According to the CDC this bacteria is responsible for 1 out of every 5 cases of meningitis in the United States and is 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 consider it one of the most preventable causes of death in the United States.

The populations at greatest risk for serious disease are children who are younger than 2 years old and adults 65 years old and older. At this time there are 2 different pneumococcal vaccines used in the United States, one for each of these two age groups.

Most adults will need only 1 shot in order to achieve lifetime immunity, although in certain medical conditions a second shot may be recommended.

You SHOULD get vaccinated with pneumococcal vaccine IF:

 1.            You are over 65 years old and have never had the vaccine.

 2.            You have had one vaccination but you were not yet 65 years old at the time AND it has been at least 5 years since your first vaccination.

 3.            You are not yet 65 years old but have a medical condition that puts you at a higher risk of getting a serious infection. A medical condition that increases your risk would include cigarette smoking, diabetes, asthma, heart or lung disease, kidney or liver disease, or an impaired immune system including HIV infection or AIDS, cancer, or an organ transplant. Additional conditions that have been linked to serious disease are having a cochlear implant to treat severe hearing loss or having fluid leaking from your brain.

4.            You are not yet 65 years old but have a medical condition that puts you at a higher risk of getting a serious infection AND it has been at least 5 years since your first vaccination.

Unlike influenza vaccine, with just one shot your pneumococcal vaccination should last a lifetime.

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What Goes Into the Flu Vaccine?

A “flu shot” is different than other vaccines because the influenza virus is different. Vaccines against other viruses like measles, mumps, and chicken pox have stayed pretty much the same over the decades they have been in use. Influenza is different because it changes its shape almost continuously, and when it does, the vaccine against it loses its effectiveness. The biggest public health challenge of influenza is keeping up with the changes in the virus so that the vaccine that protects us against it can be updated to match.

There are 3 main types of influenza virus, also caused strains: Influenza A, Influenza B, and Influenza C. Influenza A causes most cases of influenza in humans, as well as the most severe. Most widespread epidemics, called pandemics have been caused by Influenza A. The most recent formulations of influenza vaccine contain 3 different strains of influenza: 2 strains of A and one strain of B. This will probably change next year because the FDA has just approved a new formulation that will allow a total of 4 strains in the vaccine.

How likely we are to become ill with influenza depends on whether we have been exposed to it before, and how effectively our immune system can respond to it.

When we come in contact with someone sick with influenza virus, we’ll be able to fight it off more effectively if we’ve encountered that particular strain before. This is because we have antibodies left over from our previous encounter with it. If we are exposed to a strain of influenza that is new to us, we’re more likely to become sick from it because we don’t have any antibodies left over to help us fight it, and have to start making them before we can fight back.

The flu vaccine will only protect us against the 3 specific strains of influenza that it contains. Once the virus changes, the vaccine doesn’t protect against the new strain as well. In order for the flu vaccine to continue to protect us, it has to be changed to match. To do this, we need to keep track of the influenza virus so that that we’ll know when it’s made another change. Since most new strains of influenza start in China, a nationwide network of surveillance is not enough. To keep up with influenza, you need a global network, like the one used by the World Health Organization, or WHO.

The WHO tracks currently circulating strains of influenza with over 100 influenza centers in more than 100 countries. These centers funnel information into five Centers for Reference and Research on Influenza, based in London, Melbourne, Tokyo, Beijing and Atlanta. These centers report on which flu viruses are currently circulating, identify newly emerging virus strains, and assess how these match up with current influenza vaccine components.

Which strains of influenza get included in our flu vaccine? The two main criteria used to decide which of the many strains of influenza circulating around the globe are included in the upcoming vaccine are the likelihood of a particular strain to cause significant illness in the United States, and the severity of the symptoms it causes.

Each February, the WHO meets to summarize the results of their ongoing global monitoring of influenza and to make recommendations of specific strains to include in flu vaccine formulas used in the Northern Hemisphere. They meet later in the year to select strains recommended for the Southern Hemisphere.

The WHO met in Geneva on February 23, 2012 to report on global influenza patterns and make recommendations for the Northern Hemisphere vaccine. Attending that meeting was a representative from the Center for Disease Control and Prevention (CDC), based in Atlanta. On February 28th, the CDC and the Food and Drug Association’s (FDA) Vaccines and Related Biological Products Advisory Committee voted on the exact formulation of our influenza vaccine.

The decision needs to be made as soon as reasonably possible, to allow time for vaccine makers to create the nearly 200 million doses that will be needed for the US population.

National Influenza Vaccination Week is December 2-8, 2012. Have you and your loved ones had their flu shot for this year? It’s not too late. Pharmacies and medical clinics have plenty of vaccine. Please contact them today to get your flu shot.

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