Immunologic Basis And Host Response To Pneumococcal Vaccines
S. pneumoniae is a complex bacterium with 92 different polysaccharide capsular serotypes identified to date . The human airway uses numerous mechanisms to protect from colonization and invasive pneumococcal infection. Innate immune defenses, such as mucociliary escalator and an array of pattern recognition receptors that recognize bacterial proteins, help with the initial protection against the bacteria . The antiphagocytic bacterial capsule is considered to be the most important determinant of pneumococcal virulence and is important for colonization of the nasopharynx . Pneumococcal cell wall fragments and capsular polysaccharides are recognized by antibodies that bind and activate the complement system . All pneumococci serotypes can establish a carrier state and colonize in the human nasopharynx during the first few months of life. Children are the main reservoir, with colonization rates of up to 50%.
Pneumococcus bacteria and virulence factors including capsular polysaccharide. Immune response to polysaccharide and protein-polysaccharide conjugate vaccines. MHC=major histocompatibility complex TCR=T cell receptor. Adapted by permission from Reference .
Polysaccharide-based vaccines have been shown to result in decreased memory B-cell frequency, whereas conjugate protein-based vaccines increase serotype-specific memory B-cell responses, highlighting that these vaccines induce important T-celldependent memory responses .
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
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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Who Should Get The Vaccine
People over age 65. As you age, your immune system doesnât work as well as it once did. Youâre more likely to have trouble fighting off a pneumonia infection. All adults over age 65 should get the vaccine.
Those with weakened immune systems. Many diseases can cause your immune system to weaken, so itâs less able to fight off bugs like pneumonia.
If you have heart disease, diabetes, emphysema, asthma, or COPD , youâre more likely to have a weakened immune system, which makes you more likely to get pneumonia.
The same goes for people who receive chemotherapy, people who have had organ transplants, and people with HIV or AIDS.
People who smoke. If youâve smoked for a long time, you could have damage to the small hairs that line the insides of your lungs and help filter out germs. When theyâre damaged, they arenât as good at stopping those bad germs.
Heavy drinkers. If you drink too much alcohol, you may have a weakened immune system. Your white blood cells donât work as well as they do for people with a healthy immune system.
People getting over surgery or a severe illness. If you were in the hospital ICU and needed help breathing with a ventilator, youâre at risk of getting pneumonia. The same is true if youâve just had major surgery or if youâre healing from a serious injury. When your immune system is weak because of illness or injury or because itâs helping you get better from surgery, you canât fight off germs as well as you normally can.
Types Of Pneumonia Vaccine
The pneumococcal conjugate vaccine also known as Prevenar 13 offers protection against 13 strains of pneumococcal bacteria. This type is given to young children as part of their routine NHS vaccinations. Its also available for adults under 65 through our vaccination service.
The pneumococcal polysaccharide vaccine also known as Pneumovax 23 offers protection against 23 strains of pneumococcal bacteria. This type is given to adults over 65 and anyone with a very high risk of pneumonia.
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Side Effects Of The Tetanus Shot
The side effects for Tdap and Td shots are similar. The most common side effects include:
Pain, swelling, or redness where you were vaccinated
In addition to these, the Tdap shot may cause:
Nausea or vomiting
Everyones response to vaccines is different. You may have some, all, or none of the above side effects. But theyre typically mild and fast-passing. Side effects usually resolve within a few days.
Rarely, some people experience allergic reactions to the vaccines. Any vaccine may cause allergic reactions. Signs of an allergic reaction include a severe rash, swelling, or trouble breathing. This is an emergency situation. Call 911 immediately. Most healthcare providers ask you to remain at their office for 15 minutes after receiving vaccines to watch for these signs.
Side Effects Of The Pneumococcal Vaccine
Like most vaccines, the childhood and adult versions of the pneumococcal vaccine can sometimes cause mild side effects.
- redness where the injection was given
- hardness or swelling where the injection was given
There are no serious side effects listed for either the childhood or adult versions of the vaccine, apart from an extremely rare risk of a severe allergic reaction .
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Path To Improved Health
Pneumococcal vaccines can protect you against getting pneumonia, which is contagious and spreads from close, person-to-person contact. Pneumonia is an infection of the lungs and can lead to many symptoms, including:
- chest pains
- bringing up mucus when you cough
For seniors, pneumonia can be very serious and life-threatening. This is especially true if you have a chronic condition, such as diabetes or COPD. Pneumonia can also develop after youve had a case of the flu or a respiratory virus such as COVID-19. It is extremely important to stay current on flu shots each year in addition to your pneumococcal vaccines.
While PPSV23 and PCV13 do not protect against all types of pneumonia, they can make it less likely that you will experience severe and possibly life-threatening complications from the illness.
The American Academy of Family Physicians recommends that seniors who have not had either pneumococcal vaccine should get a dose of PCV13 first, and then a dose of PPSV23 6-12 months later. The vaccines cannot be given at the same time. If you have recently had a dose of PPSV23, your doctor will wait at least one year to give you PCV13.
What You Need To Know About Pneumonia And Flu Shots
This article was first published in The Montreal Gazette.
Recently, Oprah got pneumonia. Then she went on Ellen to recommend that everyone get their flu and pneumonia shots. Given that only 42 per cent of Canadians over the age of 65 got the pneumonia vaccine in 2016, maybe Oprah can get us over the 80 per cent target.
Sadly, Oprah has not always been a strong advocate for science. She gave a platform to Jenny McCarthy when she started claiming that vaccines caused her sons autism, and she also introduced the world to Dr. Oz.
But as Oprah explained to Ellen, pneumonia is no joke. Around 1.5 million people are hospitalized with pneumonia every year. Around 100,000 die in hospital and a third of people hospitalized with pneumonia die within the year.
Older patients are at greater risk and so are those with pre-existing lung disease. Smoking is also a risk factor for pneumonia, so if you need an extra incentive to stop smoking, this is it. But the main way to prevent pneumonia is with vaccines.
The problem with the pneumonia vaccine is not one of efficacy. A Cochrane meta-analysis of 18 randomized trials found that the pneumonia vaccine led to a substantial reduction in infections. The problem is which pneumonia vaccine to give people.
And if you wont listen to me, at least listen to Oprah.
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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.
Vaccines For Adults And Seniors
The National Immunisation Program schedule provides free vaccinations for adults and seniors. You may need booster doses of some vaccines to maintain high levels of protection. Most vaccines are more effective if delivered at a specific age.
The following vaccines are provided free to adults and seniors aged 65 years and over:
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Do I Need To Pay For Pneumococcal Immunisation
Vaccines covered by the National Immunisation Program are free for people who are eligible. See the NIP Schedule to find out which vaccines you or your family are eligible to receive.
Eligible people get the vaccine for free, but your health care provider may charge a consultation fee for the visit. You can check this when you make your appointment.
If you are not eligible for free vaccine, you may need to pay for it. The cost depends on the type of vaccine, the formula and where you buy it from. Your immunisation provider can give you more information.
How The Pneumococcal Vaccine Works
Both types of pneumococcal vaccine encourage your body to produce antibodies against pneumococcal bacteria.
Antibodies are proteins produced by the body to neutralise or destroy disease-carrying organisms and toxins.
They protect you from becoming ill if you’re infected with the bacteria.
More than 90 different strains of the pneumococcal bacterium have been identified, although most of these strains do not cause serious infections.
The childhood vaccine protects against 13 strains of the pneumococcal bacterium, while the adult vaccine protects against 23 strains.
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What Do I Tell My Healthcare Provider If I Get Cut Or Bitten And I Dont Know My Tetanus Vaccine Status
If you dont know when you were last vaccinated, a Tdap or Td booster is recommended if youve been cut or bit by an animal. If you dont know if youve ever been vaccinated, Tdap is preferred.
Its important to be honest with your healthcare provider. If youre not, it could delay your shot and raise your risk of infection.
Are You 65 Or Older Get Two Vaccinations Against Pneumonia
- By Gregory Curfman, MD, Assistant Professor of Medicine, Former Editor-in-Chief, Harvard Health Publishing
ARCHIVED CONTENT: As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date each article was posted or last reviewed. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
If you or a loved one is age 65 or older, getting vaccinated against pneumonia is a good idea so good that the Centers for Disease Control now recommends that everyone in this age group get vaccinated against pneumonia twice.
This new recommendation is based on findings from a large clinical trial called CAPiTA, which were published today in The New England Journal of Medicine.
Streptococcus pneumoniae, sometimes just called pneumococcus, is a common bacterium that can cause serious lung infections like pneumonia. It can also cause invasive infections of the bloodstream, the tissues covering the brain and spinal cord , and other organs and tissues. Older individuals are especially prone to being infected by Pneumococcus, and these infections are often deadly.
The dark spots are pneumonia-causing Streptococcus pneumoniae bacteria isolated from the blood of an infected person.
One caveat is that while PCV13 is effective in preventing pneumonia caused by S. pneumoniae, it does not prevent pneumonia caused by viruses or other bacteria.
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Pneumonia Vaccine: How Often Should You Get It
In the U.S., pneumococcal disease is responsible for killing thousands of people each year and about 18,000 of these are people older than 65. Thousands of adults have to stay in the hospital for proper treatment because the disease can cause several complications, including infections of the lining of the spinal cord and brain, bloodstream, and lungs. To ensure you do not have to deal with these complications, it is important to receive vaccinations for pneumococcal disease. The vaccine you receive contains the bacterium called Streptococcus pneumoniae that helps build immunity against bacterial pneumonia. While the vaccine definitely helps, you need to know when to get pneumonia vaccine. How often should you get the vaccine is anther question people ask. Here is the answer.
Should I Get A Tetanus Booster During Pregnancy
Yes. Pregnant women should get a Tdap shot between weeks 27 and 36 of pregnancy. This is recommended for every pregnancy, regardless of when your last booster was.
People that will have close contact with a newborn may also need to get a Tdap shot at least 2 weeks before the baby is born. This might include a partner, grandparents, and other family members. But these people would only need a Tdap shot if its been more than 10 years since their last one.
Its important to note that these recommendations arent to protect against tetanus. Theyre to protect newborns against pertussis . As mentioned earlier, pertussis can be very dangerous to infants. Tdap shots are the only FDA-approved vaccines that protect against pertussis for people over 10.
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Know The Facts About The Pneumonia Vaccine
Just as with a flu shot, and now the COVID-19 vaccines, some people believe that getting a pneumococcal vaccine will cause them to come down with the disease or experience long-term side effects.
This is absolutely not true, Dr. Suri says.
Not only will the pneumococcal vaccine help reduce the risk of contracting certain types of bacterial pneumonia, it also guards against serious consequences resulting from the flu and severe infections, such as .
For young children, older adults, smokers and those with other risk factors, the vaccine is a healthy choice to make.
I cant see any reason to avoid this vaccine and every reason to get it, she says.
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 .
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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.
How Do You Get Immunised Against Pneumococcal Disease
You can only get pneumococcal vaccines on their own, not as a combination vaccine. Different vaccines protect against different types of pneumococcal disease. They are all given as a needle.
There are 2 types of pneumococcal vaccine:
- Pneumovax 23 – PDF 21 KB – covers 23 strains of pneumococcal disease.
The type of vaccine used and the dosage schedule will depend on age and any conditions that put people at higher risk of getting pneumococcal disease. Your doctor can tell you which vaccine they will use for your pneumococcal immunisation.
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