If you get a flu shot, you may think you don’t need a pneumonia shot. However, this is not true. A flu shot may help to prevent complications like certain types of pneumonia, but pneumonia shots specifically target the germs that cause one of the most common types of pneumonia.
Pneumococcal vaccines (known by most people as pneumonia shots) protect against strains of a bacteria, streptococcus pneumonaie. This bacteria can cause pneumococcal disease which can manifest as pneumonia, sinus infections, meningitis or blood stream infections. Adults and children can get pneumococcal disease. The germ is passed from person to person through respiratory secretions, saliva or mucus. According to the Centers for Disease Control (CDC) 900,000 Americans get pneumococcal disease each year, causing over 400,000 hospitalizations. 90% of invasive pneumococcal disease occurs in older adults, with the majority of deaths (95%) from this illness occurring in the same age group.
Children routinely get vaccinated with pneumococcal vaccines. You can get vaccinated as well which can help to greatly reduce your chances of getting pneumococcal disease. There are two types recommended for adults 65 and older. One shot has been around for quite a few years. It is PPSV23 (Pneumococcal Polysaccharide Vaccine). You may have known this as Pneumovax. The other format is PCV13 (Pneumococcal Conjugate Vaccine) and is a newer vaccine. You may know it as Prevnar. The PPSV23 protects against 23 strains of streptococcus pneumonaie and the PCV13 protects against 13 strains. If you got a pneumonia shot (pneumococcal vaccine) as an adult before August 2014, it is likely that you received PPSV23.
The recommendations for how these shots are administered have changed since the first pneumonia shots were introduced. At that time, it was believed that an older person only needed one shot in their lifetime. Over time, the guidelines changed and it was recommended that certain people get a booster, depending on their age of the first pneumonia shot and/or their health status. With the advent of the new vaccine, guidelines have again changed. The guidelines outlined here are for adults 65 and over. (Specific guidelines exist for persons less than 65 with specific health conditions or behaviors. For example, PPSV23 is recommended for all smokers and persons with asthma age 19-64. Check with your health care provider for your condition/age group.)
- If you are 65 or older and have never had a pneumonia shot, you should get the PCV13 first, followed by a PPSV23 immunization 6 to 12 months later. (Generally you have to wait a year for insurance to cover it.)
- If you had a PPSV23 shot at age 65 or older, you should get the PCV13 a year or more after the PPSV23. Generally, you do not need another PPSV23.
- If you had a PPSV23 shot before age 65, you should get a PCV13 at age 65 or older and with at least a year after the PPSV23, followed by a second PPSV23 6-12 months later (but again at least a year for insurance to cover the cost) if 5 years or more have passed since the first PPSV23.
Note: The two formats should not be administered at the same time. However, you can get a pneumonia shot when you get a flu shot.
If you are wondering why a vaccine with less strains represented (the PCV 13) would be recommended to be given first (instead of the PPSV 23) to those 65 and over who have never had a pneumonia shot, it has to do with the way the body produces an immune response. This response is best when given in this sequence. It is a long scientific explanation that is best left with the scientists. For us, we should follow the recommendations that are created by the Advisory Committee on Immunization Practices (ACIP) as they have digested the science in order to create the recommendations for us.
While the recommendations may seem a bit complicated, you can check with your healthcare provider to see which vaccine you should receive. The important thing is that there is a way to prevent pneumococcal disease and you should take advantage of it. For more information, visit www.cdc.gov or www.immunize.org. Quinnipiack Valley Health District residents (Bethany, Hamden, North Haven and Woodbridge) with questions can call QVHD, 203 248-4528. This column was authored by V. Deborah Culligan, QVHD staff.