Pneumonia Vaccine

by Sara Heineman

Did you know there are two different pneumonia vaccines? Are you confused about which one you should get? Well, here’s the scoop on the alphabet soup of acronyms.

First, you need a little background on pneumonia. There are 90 different strains of Streptococcus pneumonia bacteria that can cause severe pneumonia. The most common type of disease is lung infection, but pneumonia bacteria can also cause ear and sinus infections.

Less commonly, some strains cause invasive diseases such as infections in the blood (bactermia) or in the covering of the brain and spinal cord (meningitis). These conditions are very serious, especially for older adults.

Pneumonia impacts our health care system heavily. The Centers for Disease Control and Prevention estimates about 400,000 hospitalizations per year related to lung infections from pneumonia. Of these cases, 5 to 7 percent die. Older adults have a higher death rate. The CDC estimates 12,000 cases of blood infections each year. About 20 percent of these cases result in death. For older adults with blood infections, that number is 60 percent.

Meningitis caused by pneumonia occurs 3,000 to 6,000 times per year, with eight percent fatality in children and 22 percent in adults. Most survivors have neurological problems.

In addition, many strains of pneumonia show increasing resistance to the antibiotics used to treat them. This makes treatment more difficult. The facts make a clear case for why older adults need a pneumonia vaccine.

Now how do you decide which pneumonia vaccine to get? We know the first pneumonia vaccine as the
“classic pneumonia shot.” Researchers began working on it in the early 1900s, but it was first used in the late 1970s. Over time, pharmaceutical companies improved the vaccine. Today, we call this vaccine Pneumovax 23, or PPSV23. The “23” means that it protects against 23 strains of pneumonia.

We know the second pneumonia vaccine as Prevnar13, or PCV13. The “13” means that it protects against 13 strains of pneumonia. Researchers first developed this vaccine for use in children. It works in a different way than the classic pneumonia shot. It protects against fewer strains of pneumonia, but it creates a stronger immune response. This vaccine also helps get rid of the pneumonia bacteria in the
nasal passages, which helps stop it from spreading to others.

Both vaccines cover the most common strains of pneumonia. They differ a little in how effective they
are against invasive disease. PPSV23 (the “classic pneumonia shot”) is considered to be 60 percent to
70 percent effective in preventing invasive disease for all age groups. The PCV13 vaccine is considered
75 percent effective against invasive disease in adults 65 and older, and more than 90 percent effective in preventing invasive disease in children. PCV13 is also about 45 percent effective in preventing most pneumonia lung infections in adults 65 years and older.

So what are the recommendations for who should get each vaccine? Adults 65 and older routinely get the PPSV23 vaccine. Health care professionals also recommend this vaccine for people 2 and older with certain medical conditions. These medical conditions include weakened immune systems, cochlear implants, asthma, chronic heart or lung disease, or diabetes. People who smoke cigarettes should also get PPSV23. Certain Native American populations, including Alaska Native, Navajo and Apache, have a higher risk of pneumonia, so health care professionals also recommend PPSV23 for these populations.

Health care providers give PCV13 as part of routine childhood immunizations. The CDC recently added it as a recommendation for adults 65 years and older. Certain age groups with specific medical conditions should also get this vaccine. The medical conditions include anatomic asplenia (including sickle-cell disease) conditions that weaken the immune system, cochlear implants or cerebrospinal fluid leak.

The guidelines for PPSV23 and PCV13 overlap, depending on age group and medical conditions. (You should be aware that only a few of the medical conditions are listed above.) The recommendation for adults 65 years and older is to receive both types of vaccine.

You can get help from several resources. The CDC offers a survey to help you determine which vaccines might be right for you. Your health care provider can help you sort out the best vaccine for you. And the expert nurses on staff at the Outpatient Immunization Clinic at the Missoula City-County Health Department can assess your medical history and help you determine what pneumonia vaccine is right for you and if you need any booster doses.

Call us call at 258-4292, or come to our walk-in immunization clinic. We are located at 301 W. Alder
St., open from 9 a.m. to 4:30 p.m. Monday, Tuesday, Thursday and Friday, and 10 a.m. to 4:30 p.m.
Wednesday.

Sara Heineman is the Missoula City-County Health Department Outpatient Clinic nursing supervisor
and can be reached at 258-4987 or sheineman@co.missoula.mt.us.

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