Concurrent Administration Of Vaccines
Pneumococcal vaccines may be administered concomitantly with other vaccines, with the exception of a different formulation of pneumococcal vaccine . There should be at least an 8 week interval between a dose of pneumococcal conjugate vaccine and a subsequent dose of Pneu-P-23 vaccine, and at least a 1 year interval between a dose of Pneu-P-23 vaccine and a subsequent dose of pneumococcal conjugate vaccine refer to Immunocompromised persons for information regarding administration of pneumococcal vaccines to HSCT recipients. Different injection sites and separate needles and syringes must be used for concurrent parenteral injections. Refer to Timing of Vaccine Administration in Part 1 for additional information about concurrent administration of vaccines.
When To Get The Vaccine
Thereâs no such thing as pneumonia season, like flu season. If you and your doctor decide that you need to have a pneumonia vaccine, you can get it done at any time of the year. If itâs flu season, you can even get a pneumonia vaccine at the same time that you get a flu vaccine, as long as you receive each shot in a different arm.
Summary Of Information Contained In This Naci Statement
The following highlights key information for immunization providers. Please refer to the remainder of the Statement for details.
Streptococcus pneumoniae is a bacterium that can cause many types of diseases including invasive pneumococcal disease , and community-acquired pneumonia .
For the prevention of diseases caused by S. pneumoniae in adults, two types of vaccines are available in Canada: pneumococcal 23-valent polysaccharide vaccine containing 23 pneumococcal serotypes and pneumococcal 13-valent conjugate vaccine containing 13 pneumococcal serotypes.
NACI has been tasked with providing a recommendation from a public health perspective on the use of pneumococcal vaccines in adults who are 65 years of age and older, following the implementation of routine childhood pneumococcal vaccine programs in Canada.
Information in this statement is intended for provinces and territories making decisions for publicly funded, routine, immunization programs for adults who are 65 years of age and older without risk factors increasing their risk of IPD. These recommendations supplement the recent NACI recommendations on this topic that were issued for individual-level decision making in 2016.
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The Flu Pneumonia And Inflammation Create A Deadly Threat
Pneumococcal pneumonia can follow other viral infections, particularly influenza, says William Schaffner, M.D., an infectious disease specialist at the Vanderbilt University School of Medicine. The biology behind it:The flu virus attaches to, and infects, the cells lining the mucous membranes in the back of the throat, nose and bronchial tubes. Normally, the cells eject infectious agents out of the body via the nose or mouth, or they’re simply swallowed. But when impaired by the flu, the cells lining these membranes allow the bacteria to slip down into the bronchial tubes and trigger a secondary infection, in the lungs. The infection inflames the air sacs in the lungs, causing them to fill with pus and fluid. That not only makes it hard to breathe but can allow bacteria to escape into the bloodstream, causing an infection called sepsis, an aggressive inflammatory response that can, ultimately, lead to organ failure.
Pneumococcal pneumonia, of course, is also likely be a complication of respiratory syncytial virus , a common and highly contagious winter lung infection, whichuncharacteristicallyspread this summer, and SARS-CoV-2, the virus that causes COVID-19. However, the pneumococcal vaccine wont shield you from pneumonia that results from either of them. As Schaffner puts it, Pneumonia from Covid is a different sort of pneumonia.
Medical Conditions Resulting In High Risk Of Ipd
Table 1: Medical Conditions Resulting in High risk of IPD
IPD is more common in the winter and spring in temperate climates.
Spectrum of clinical illness
Although asymptomatic upper respiratory tract colonization is common, infection with S. pneumoniae may result in severe disease. IPD is a severe form of infection that occurs when S. pneumoniae invades normally sterile sites, such as the bloodstream or central nervous system. Bacteremia and meningitis are the most common manifestations of IPD in children 2 years of age and younger. Bacteremic pneumococcal pneumonia is the most common presentation among adults and is a common complication following influenza. The case fatality rate of bacteremic pneumococcal pneumonia is 5% to 7% and is higher among elderly persons. Bacterial spread within the respiratory tract may result in AOM, sinusitis or recurrent bronchitis.
Worldwide, pneumococcal disease is a major cause of morbidity and mortality. The World Health Organization estimates that almost 500,000 deaths among children aged less than 5 years are attributable to pneumococcal disease each year. In Canada, IPD is most common among the very young and adults over 65 years of age.
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Questions To Ask Your Doctor
- When should I make an appointment to get each type of pneumococcal vaccine?
- Should I still get the vaccines if Ive recently had pneumonia?
- Should I wait to turn 65 before I get each dose of pneumococcal vaccines?
- If I have a negative reaction to one type of pneumococcal vaccine, am I likely to have that same reaction to the other?
Funding was provided for these pneumococcal resources through an unrestricted grant from Pfizer Independent Grant for Learning and Change .
Do You Need To Get Both Vaccines
Most people do not, but some may, depending on age and other health conditions.
All healthy children should get PCV13, and children with certain health conditions should also receive PPSV23. When both vaccines are needed, they are given 8 weeks apart, and PCV13 is given first.
Adults aged 65 and over
All adults aged 65 and older should get PPSV23. If you are a healthy adult over 65, you should talk to your healthcare provider about whether you need PCV13.
PCV13 used to be recommended for all adults over age 65, but the ACIP recently changed its recommendations. This is because, as more children have been vaccinated with PCV13, the types of pneumococci that this vaccine protects against are less likely to spread and infect older adults. PCV13 can still be given, and your healthcare provider can help you decide if it is right for you.
Adults younger than 65
For adults younger than 65, PPSV23 is recommended in certain situations. If you smoke or have a chronic illness, like asthma, chronic obstructive pulmonary disease , or liver disease, you should get PPSV23 at a younger age. Adults with other conditions, like a weakened immune system, should have both vaccines before age 65.
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What Is The Pneumonia Shot
The pneumonia shot is a vaccine that keeps you from getting pneumonia. There are two types of vaccines. The pneumococcal conjugate vaccine is primarily for children under age two, though it can be given to older ages, as well. The pneumococcal polysaccharide vaccine is for adults over age 65.
The pneumonia vaccine for older adults is one dose. Unlike the flu vaccine, you dont get it every year.
The vaccine teaches your body to make proteins that will destroy the pneumonia bacteria. These proteins are called antibodies and they will protect you and keep you from getting infected. The pneumonia vaccines dont have live bacteria or viruses in them, so you wont get pneumonia from the vaccine.
You should have the pneumonia vaccine if you:
- Are over age 65
- Have a long-term health problem
Vaccines dont prevent all pneumonia, but people who get the shot dont get as sick as those who dont have it. Benefits of the vaccine include:
- Milder infections
- Ringing in your ears
If you know you dont like needles or feel worried before getting a vaccine, you can try to look away while you have the shot. You can also try a relaxation technique like deep breathing or visualization to help you feel calm.
Older people are more likely to have long-term health problems that can make getting an infection dangerous. The pneumonia shot is recommended for most people.
Effectiveness Of The Pneumococcal Vaccine
Children respond very well to the pneumococcal vaccine.
The introduction of this vaccine into the NHS childhood vaccination schedule has resulted in a large reduction in pneumococcal disease.
The pneumococcal vaccine given to older children and adults is thought to be around 50 to 70% effective at preventing pneumococcal disease.
Both types of pneumococcal vaccine are inactivated or “killed” vaccines and do not contain any live organisms. They cannot cause the infections they protect against.
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What You Should Know About Pneumonia
Pneumonia is an infection in one or both lungs that typically stems from several kinds of germs, most often bacteria and viruses.
Symptoms can develop gradually or suddenly. They include:
- Chest pain.
- Loss of appetite.
Early detection is often challenging because many people with these symptoms assume they have a cold or the flu.
Its important to also note that the vaccine helps protect against some but not all bacterial pneumonia.
There are dozens of different types of bacterial pneumonia, says Dr. Suri. The vaccine will certainly reduce your risk of the most common bacterial pneumonia.
What Is The Pneumonia Vaccine Exactly
The pneumonia vaccine helps prevent pneumococcal disease, which is any kind of illness caused by the Streptococcus pneumoniae bacteria. That includes pneumonia and meningitis, according to the Centers for Disease Control and Prevention . There are actually two types of pneumococcal vaccines in the US:
- Pneumococcal conjugate vaccine, known as PCV13
- Pneumococcal polysaccharide vaccine, known as PPSV23
PCV13 protects against 13 types of bacteria that cause pneumococcal disease, the CDC says, and specifically works against the most serious types of pneumococcal disease, including pneumonia, meningitis, and bacteremia. PPSV23 protects against 23 types of bacteria that cause pneumococcal disease and helps prevent infections like meningitis and bacteremia.
The pneumococcal vaccines can be lifesaving. Pneumococcal pneumonia kills about one in 20 older adults who get it, according to the CDC. The vaccines offer a lot of protection. PCV13 can protect three in four adults ages 65 and up against invasive pneumococcal disease and nine in 20 adults ages 65 and older against pneumococcal pneumonia, per CDC data. One shot of PPSV23 protects up to 17 in 20 healthy adults against invasive pneumococcal disease.
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Flu And Pneumonia Shots
Having the flu can be dangerous for anyone. But it is extra risky for people with diabetes or other chronic health problems. Having diabetes means having more instances of high blood sugar than a person without diabetes. High blood sugar hinders your white blood cells ability to fight infections.
Beyond people living with diabetes, flu is also extra risky for people with heart disease, smokers and those with chronic lung disease, people who have an impaired immune system , very young children, and people living in very close quarters, such as college dorms, military barracks, or nursing homes.
Who Needs Vaccination
Pneumonia vaccination is not recommended for everyone. The vaccines are primarily used in persons who are at increased risk of serious illness. These include:
- Infants and children as part of their routine vaccination schedule
- Persons over the age of 65
- Persons with compromised or weakened immune systems, including those with chronic illness such as HIV, heart disease, liver disease, kidney failure, and diabetesï»¿ï»¿
- Organ transplant recipients and person undergoing chemotherapy, both of whom have weakened immune systems and exposure to immune suppressive drugs
- Persons with chronic respiratory illnesses such as asthma, emphysema, chronic obstructive pulmonary disease ï»¿ï»¿
- Persons who smoke or are heavy drinkers
- Persons recovering from surgery or a serious illness
Vaccination is currently not recommended for persons between 18 and 64 who are healthy. The same applies to anyone who has had a prior allergic reaction to the vaccine or has a known allergy to any of the components of the vaccine.
When To See A Doctor
A person who is over 65 years of age should talk to their doctor about which pneumonia vaccine may be best for them. The doctor can help determine whether they should get the vaccination, which vaccination to get, and when to get it.
Parents and caregivers of young children should talk to a pediatrician about the schedule for the pneumonia vaccination. The pediatrician can also address any questions or concerns about the safety and effectiveness of the vaccination.
A person does not need to see a doctor for mild reactions to the vaccine, such as tenderness at the injection site, fever, or fatigue.
However, if a person experiences any life threatening side effects, they should seek emergency help immediately.
Signs and symptoms of allergic reactions in children may include:
- respiratory distress, such as wheezing
How Do The Pneumonia Vaccines Work
Like all vaccines, pneumococcal vaccines work by showing the immune system a version of the microbe, or a part of it, that is responsible for the infection. The pneumococcal vaccine contains part of the pneumococcus bacterias outer shell, made of molecules called polysaccharides. The immune system learns to recognize it, attack it, and defend the body against it, should it ever come into contact with the real bacteria.
The body does this by making antibodies against the shell of the pneumococcus bacteria. These antibodies stay in your bloodstream as part of your immune system. If you are exposed to pneumococci in the future, the antibodies recognize the bacterias shell and launch a targeted defense.
There are strains of pneumococcus, so the vaccines are made up of molecules from many of those strains.
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Who Needs One Or Two Pneumonia Vaccines
There are two pneumococcal vaccines, each working in a different way to maximize protection. PPSV23 protects against 23 strains of pneumococcal bacteria. Those 23 strains are about 90- to 95-plus percent of the strains that cause pneumonia in humans, Poland explains. PCV13, on the other hand, is a conjugate vaccine that protects against 13 strains of pneumococcal bacteria. PCV13 induces immunologic memory, he says. Your body will remember that it has encountered an antigen 20 years from now and develop antibodies to fight it off.
In order to get the best protection against all strains of bacteria that cause pneumonia, the CDC has long recommended that everyone 65 or older receive both vaccines: PCV13 , followed by the pneumococcal polysaccharide vaccine at a later visit. But the agency is now saying that PCV13 may not be necessary for healthy people 65 and older, suggesting that the decision be left up to patients and their physicians as to whether that extra skin prick is appropriate.
“Anyone who reaches the age of 65 and is in any way immunocompromised or has any of the listed indications for pneumococcal vaccine because they’re in a high-risk group for example, if they have diabetes, heart disease or lung disease, or are a smoker should continue to get both vaccines, says Schaffner.
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What If It Is Not Clear What A Person’s Vaccination History Is
When indicated, vaccines should be administered to patients with unknown vaccination status. All residents of nursing homes and other long-term care facilities should have their vaccination status assessed and documented.
How long must a person wait to receive other vaccinations?
Inactivated influenza vaccine and tetanusvaccines may be given at the same time as or at any time before or after a dose of pneumococcus vaccine. There are no requirements to wait between the doses of these or any other inactivated vaccines.
Vaccination of children recommended
In July 2000, the American Academy of Pediatrics and the CDC jointly recommended childhood pneumococcal immunization, since pneumococcal infections are the most common invasive bacterial infections in children in the United States.
“The pneumococcal conjugate vaccine, PCV13 or Prevnar 13, is currently recommended for all children younger than 5 years of age, all adults 65 years or older, and persons 6 through 64 years of age with certain medical conditions,” according to the 2014 AAP/CDC guidelines. “Pneumovax is a 23-valent pneumococcal polysaccharide vaccine that is currently recommended for use in all adults 65 years of age or older and for persons who are 2 years and older and at high risk for pneumococcal disease . PPSV23 is also recommended for use in adults 19 through 64 years of age who smoke cigarettes or who have asthma.”
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Pneumonia Can Be Preventedvaccines Can Help
Some patients with coronavirus disease 2019 have had pneumonia. Learn more about COVID-19.
Pneumonia, an infection of the lungs, needlessly affects millions of people worldwide each year.
Pneumonia can often be prevented and can usually be treated.
Lower your risk of pneumonia with vaccines and other healthy living practices.
CDC data showed that in the United States during 2018:
- 1.5 million people were diagnosed with pneumonia in an emergency department
- Approximately 44,000 people died from pneumonia
Most of the people affected by pneumonia in the United States are adults. Vaccines and appropriate treatment could prevent many of these deaths.
Who Should Get The Pneumococcal Vaccine
Anyone over the age of 18 with certain risk factors is eligible to receive the pneumococcal vaccine at Allcare Pharmacy. Your pharmacist is happy to advise you if the vaccine is appropriate for you.
Pneumococcal vaccination is advised for:
- Everybody aged 65 years and over
- Adults aged 18 years and over with:
- Diabetes mellitus
- Chronic heart, respiratory, renal or liver disease
- Sickle cell disease
- Disorders of the immune system including cancer, HIV, and transplant patients
- Those who are exposed to fumes through their work e.g. welders
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