The Shot: Seasonal Flu Or Influenza Vaccine
How often: Yearly, usually in the fall.
What to expect: It is straightforwardjust a jab in the shoulder.
After hearing about the efficiency rates of the Covid-19 vaccines and their ability to stop variants, you might think that the flu vaccine has some catching up to do. The flu vaccine is maybe 50%, 60%, 70% at best, says Peter Katona, M.D., UCLA Fielding School of Public Health professor of epidemiology and of medicine at the David Geffen School of Medicine in Los Angeles.
This flu virus is a sneaky bugger that mutates with fervor. Each year, the new flu vaccine is created to protect against a strain of the flu virus that scientists believe will emerge. Some years, they guess right other years, not so much. Either way, any vaccine is better than none, priming your immune system for what might be ahead.
Generally speaking, there are almost no reasons why people shouldn’t be getting a COVID and a flu shot, Dr. Wolfe says. We know they are effective. We know that theyre safe. So, the mere fact that we can’t quite predict how busy the flu season should be, shouldn’t be a reason for folks to put their head in the sand, and think that they shouldnt do it.
What To Know About The Pneumococcal Vaccine
Who needs it: The CDC recommends one pneumococcal vaccine for adults 19 to 64 with certain risk factors . If you work around chronically ill people say, in a hospital or nursing home you should get the vaccine, even if you’re healthy. People 65 and older can discuss with their health care provider whether they should get PCV13 if they haven’t previously received a dose. A dose of PPSV23 is recommended for those 65 and older, regardless of previous inoculations with pneumococcal vaccines.
How often: Space immunizations out. You should receive a dose of the pneumococcal conjugate vaccine , then, a year later, a dose of pneumococcal polysaccharide vaccine . People with any of the risk factors should get one dose of PCV13 and PPSV23 before age 65, separated by eight weeks.
Why you need it: Pneumococcal disease, which can cause pneumonia, kills around 3,000 people a year. Young children and those over 65 have the highest incidence of serious illness, and older adults are more likely to die from it.
Editors note: This article was published on Oct. 26, 2020. It was updated in September 2021 with new information.
Also of Interest
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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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.
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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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.
Who Is Recommended To Get Prevnar 20
Although adults ages 18 and older are eligible to receive Prevnar 20, its not yet certain how Prevnar 20 will be used alongside Prevnar 13 and Pneumovax 23.
The CDCs Advisory Committee on Immunization Practices develops recommendations on how to use vaccines. Although Prevnar 20 was approved last week, the CDC and ACIP have yet to incorporate Prevnar 20 into its overall recommendations.
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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 .
Common And Local Adverse Events
Pneumococcal conjugate vaccine
Studies of Pneu-C-13 vaccine indicated that irritability decreased appetite increased or decreased sleep and pain, swelling and redness at the injection site after the toddler dose and in older children, are common side effects. Low grade fever occurred in 20% to 30% or more of vaccine recipients. In adults over 50 years of age, the most commonly reported side effects included pain at the injection site, fatigue, headache and new onset of myalgia, with fever above 38Â°C occurring in approximately 3% of vaccine recipients.
Pneumococcal polysaccharide vaccine
Reactions to Pneu-P-23 vaccine are usually mild. Soreness, redness and swelling at the injection site occur in 30% to 60% of vaccine recipients and more commonly follow SC administration than IM administration. Occasionally, low grade fever may occur. Re-immunization of healthy adults less than 2 years after the initial dose is associated with increased injection site and systemic reactions. Studies have suggested that re-vaccination after an interval of at least 4 years is not associated with an increased incidence of adverse side effects. However, severe injection site reactions, including reports of injection site cellulitis and peripheral edema in the injected extremity, have been documented rarely with Pneu-P-23 vaccine in post-marketing surveillance, even with the first dose. Multiple re-vaccinations are not recommended refer to Booster doses and re-immunization.
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Should You Get A Flu Shot
In general, every person with diabetes needs a flu shot each year. Talk with your doctor about having a flu shot. Flu shots do not give 100% protection, but they do make it less likely for you to catch the flu for about six months.
For extra safety, it’s a good idea for the people you live with or spend a lot of time with to get a flu shot, too. You are less likely to get the flu if the people around you don’t have it.
The best time to get your flu shot is beginning in September. The shot takes about two weeks to take effect.
If youre sick , ask if you should wait until you are healthy again before having your flu shot. And don’t get a flu shot if you are allergic to eggs.
You are advised to continue to take the general precautions of preventing seasonal flu and other communicable illnesses and diseases:
- Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash. If you dont have a tissue, cough or sneeze into your elbow, not your hand.
- Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
- Avoid touching your eyes, nose, or mouth. Germs spread that way.
- Try to avoid close contact with sick people.
- If you get sick, stay home from work or school and limit contact with others to keep from infecting them.
Children At High Risk Of Ipd
Infants at high risk of IPD due to an underlying medical condition should receive Pneu-C-13 vaccine in a 4 dose schedule at 2 months, 4 months and 6 months followed by a dose at 12 to 15 months of age. Table 3 summarizes the recommended schedules for Pneu-C-13 vaccine for infants and children at high risk of IPD due to an underlying medical condition by pneumococcal conjugate vaccination history.
In addition to Pneu-C-13 vaccine, children at high risk of IPD due to an underlying medical condition should receive 1 dose of Pneu-P-23 vaccine at 24 months of age, at least 8 weeks after Pneu-C-13 vaccine. If an older child or adolescent at high risk of IPD due to an underlying medical condition has not previously received Pneu-P-23 vaccine, 1 dose of Pneu-P-23 vaccine should be administered, at least 8 weeks after Pneu-C-13 vaccine. Children and adolescents at highest risk of IPD should receive 1 booster dose of Pneu-P-23 vaccine refer to Booster doses and re-immunization. Refer to Immunocompromised persons for information about immunization of HSCT recipients.
Table 3: Recommended Schedules for Pneu-C-13 Vaccine for Children 2 months to less than 18 years of age, by Pneumococcal Conjugate Vaccination History
|Age at presentation for immunization||Number of doses of Pneu-C-7, Pneu-C-10 or Pneu-C-13 previously received|
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Who Should Not Get The Vaccine
People should not get the vaccine if they have had a life threatening allergic reaction to a previous dose.
Additionally, a person should not undergo vaccination if they have had an allergic reaction to medication containing diphtheria toxoid or an earlier form of the pneumonia vaccination .
Lastly, people who are sick or have allergic reactions to any of the ingredients of the vaccine should talk to a doctor before getting the shot.
A pneumonia shot will not reduce pneumonia. However, it helps prevent invasive pneumococcal diseases, such as meningitis, endocarditis, empyema, and bacteremia, which is when bacteria enter the bloodstream.
Noninvasive pneumococcal disease includes sinusitis.
There are two types of pneumonia shots available. Which type a person gets depends on their age, whether or not they smoke, and the presence of any underlying medical conditions.
The two types are:
- Pneumococcal conjugate vaccine : Healthcare providers recommend this vaccine for young children, people with certain underlying conditions, and some people over the age of 65 years.
- Pneumococcal polysaccharide vaccine : Healthcare providers recommend this vaccine for anyone over 65 years of age, people with certain underlying conditions, and people who smoke.
According to the
- roughly 8 in 10 babies from invasive pneumococcal disease
- 45 in 100 adults 65 years or older against pneumococcal pneumonia
- 75 in 100 adults 65 years or older against invasive pneumococcal disease
Are There Side Effects
About half of those who are given pneumococcal vaccine have very mild side effects, such as redness and pain at the injection site. Less than 1 percent of those getting the vaccine may develop fever, muscle aches and severe local reactions. Serious side effects, such as dangerous allergic reactions, have rarely been reported. As with any drug or vaccine, there is a rare possibility that allergic or more serious reactions or even death could occur. The pneumonia shot cannot cause pneumonia because it is not made from the bacteria itself but from an extract that is not infectious.
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How Far Apart Are Pneumonia Shots
You can administer the first dose as early as 6 weeks of age. CDC recommends a fourth dose at 12 through 15 months of age. For children vaccinated when they are younger than 12 months of age, the minimum interval between doses is 4 weeks. Separate doses given at 12 months of age and older by at least 8 weeks.
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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How Does It Compare To Other Pneumococcal Vaccines
Like Prevnar 20, Prevnar 13 is a conjugate vaccine that works in a similar way to protect you against pneumococcal disease. Pneumovax 23, on the other hand, is a polyvalent vaccine that works by producing antibodies against pneumococcal bacteria.
No vaccine is 100% effective at preventing disease, but all three pneumococcal vaccines Prevnar 13, Prevnar 20, and Pneumovax 23 are considered safe and effective for helping protect against pneumococcal disease. And this latest FDA approval demonstrates ongoing pneumococcal vaccine development, with more candidates currently in the pipeline.
Lets review some key differences between the vaccines.
What Are The Side Effects
Prior to its approval, Prevnar 20 was studied in six clinical trials. Across these studies, reported side effects were similar for all ages. Most of them were mild to moderate in severity. Like many other vaccines, pain at the injection site is reported as the most common side effect.
Additional common side effects of Prevnar 20 can include:
Injection site swelling
Although most of these side effects happened within 7 to 10 days of the shot, less than 2% of people experienced one or more serious adverse events within 6 months. However, it hasnt been confirmed that these events were due to the vaccine.
The safety of Prevnar 20 was studied in people who have no history of pneumococcal vaccination, in individuals who have previously received Prevnar 13, and in individuals who have previously received Pneumovax 23. No notable safety differences were seen between the vaccines.
Next, well discuss who should receive Prevnar 20.
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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.
Tdap Vaccine And/or The Td Booster
Who needs it: The Tdap vaccine came out in 2005, and along with protecting against tetanus and diphtheria, like the vaccine it replaced, it also includes new, additional protection against whooping cough, also known as pertussis. If you cant remember ever getting this shot, you probably need it. And doing so, says Katz, can also count for one of the Td boosters youre supposed to get every 10 years.
How often: You get Tdap only once, and after that, you still need the Td booster every 10 years. Otherwise, your protection against tetanus and diphtheria will fade.
Why you need it: Due to a rise in whooping cough cases in the U.S., you really do need to be vaccinated against it, even if youre over 65. In the first year after getting vaccinated, Tdap prevents the illness in about 7 out of 10 people who received the vaccine.
Talk to your doctor if you: Have epilepsy or other nervous system problems, had severe swelling or pain after a previous dose of either vaccine, or have Guillain-Barré syndrome.
Parting shot: This vaccine is especially crucial for people who have close contact with infants younger than 12 months of age including parents, grandparents, and child care providers.
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