There are now two pneumococcal vaccines now available:
- Pneumococcal polysaccharide vaccine, PPSV 23, brand name Pneumovax
- Pneumococcal conjugate vaccine, PCV 13, brand name Prevnar 13
Depending on your underlying medical conditions, you may need one or both of these vaccines. Some patients will need an extra vaccine dose.
Pneumococcal disease is a known killer. The major types of pneumococcal disease are pneumonia, bacteremia (blood infection), and meningitis (infection of the covering of the brain and spinal cord). Each year, about 900,000 Americans get pneumonia, the most common form of the pneumococcal disease in adults, and 45,000 to 65,000 die from it.
Who should be given the pneumonia shot?
Individuals at high risk of infection: people 65 and older; those with chronic medical problems including HIV and other immune-compromising conditions, diabetes, people with heart, lung, liver, or kidney problems.
Asthmatics and smokers are also on that list. All smokers and asthmatics need the PPSV 23 pneumococcal vaccine because they are at greater risk of severe disease.
Asthma increases the risk of serious pneumococcal disease: pneumonia, meningitis, infections of joint fluid and bone. These infections that can be life-threatening. Several years ago, a study in the New England Journal of Medicine found that the risk of serious pneumococcal infection doubled in those with even mild asthma. For high-risk asthma patients, the risk was four times greater, compared to people without asthma.
All adults with immunocompromising conditions should receive PCV 13 pneumococcal vaccination.
Rates of invasive pneumococcal disease in immunocompromised adults (including HIV and hematologic cancer) are about 20 times higher than for adults without high-risk medical conditions
The newest change in pneumococcal vaccination is for seniors: Everyone 65 and older should receive both PPSV 23 and PCV 13 pneumococcal vaccinations.
The incidence of severe pneumococcal disease in adults aged 65 years or older is nearly 10 times that in younger adults (aged 18 to 34 years). Although PPSV23 vaccination has been previously recommended for all adults aged 65 years or older, about 13 500 cases of the severe pneumococcal disease occurred in 2013 among adults in this age group. Pneumococcal serotypes of PCV13 were to blame for up to 25% of “invasive” disease and 10% of community-acquired pneumonia cases. The Community-Acquired Pneumonia Immunization Trial in Adults (CAPiTA), found that PCV13 vaccination was 75% effective in preventing vaccine-type severe pneumococcal disease and 45% effective in preventing vaccine-type pneumonia. Adults age 65 and older need BOTH vaccines but they cannot be given at the same time.