How Often To Get Pneumonia Vaccine After 65

Are The Pneumonia Vaccines Safe

Yes, pneumonia vaccines are safe. Like all vaccines, they go through rigorous scientific testing and review. Although both pneumococcal vaccines can cause mild side effects, severe reactions to the vaccines are rare. In one study of adults over age 70 who received the PCV13 and PPSV23 vaccines, there was only one adverse event that was related to the vaccine.

Allergic reactions to vaccines are rare, but they can occur and may be serious. If you have had an allergic reaction to one of the ingredients in the pneumococcal vaccines or to a prior dose of a pneumococcal vaccine, you should not get vaccinated without talking to your healthcare provider first.

If you have questions about whether the pneumonia vaccines are safe for you, discuss this with your healthcare provider. You can also find information about pneumococcal vaccine safety here.

What Does The Pneumonia Vaccine Do

Pneumonia is a serious condition that attacks the lungs, causing coughing, fever, and difficulty breathing. It often requires hospitalisation, and can be life-threatening especially for the elderly or for people with weakened immune systems.

Pneumonia can be caused by viruses and fungi, but its usually caused by a bacterial infection. This is why both types of the pneumonia vaccine work by generating antibodies to kill pneumococcal bacteria. Once youve had the vaccine, your body will be able to use these antibodies to quickly fight off the bacteria strains that cause pneumonia.

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.

1. What

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.

• Immunization and vaccines

2. Who

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.

3. How

4. Why

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Which Pneumonia Vaccine Is Best

There is no best pneumonia vaccine. The two available pneumonia vaccines are different, and which one is best for you depends on how old you are and whether or not you have certain medical conditions.

The main difference between Prevnar 13 and Pneumovax 23 is the number of pneumococcus strains the vaccine protects against.

• PCV13 contains polysaccharides from 13 types of pneumococcal bacteria and is mainly given to young children.

• PPSV23 contains polysaccharides from 23 types of pneumococcal bacteria and is mainly given to older adults.

Whats The Difference Between Pcv13 And Ppsv23

• Both vaccines help prevent pneumococcal complications like bacteremia and meningitis.
• Youll need more than one pneumonia shot during your lifetime. A 2016 study found that, if youre over 64, receiving both the PCV13 shot and the PPSV23 shot provide the best protection against all the strains of bacteria that cause pneumonia.
• Dont get the shots too close together. Youll need to wait about a year in between each shot.
• Check with your doctor to make sure youre not allergic to any of the ingredients used to make these vaccines before getting either shot.

• a vaccine made with diphtheria toxoid
• another version of the shot called PCV7
• any previous injections of a pneumonia shot

• are allergic to any ingredients in the shot
• have had severe allergies to a PPSV23 shot in the past
• are very sick

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What Does Shared Clinical Decision

• PCV13 is a safe and effective vaccine for older adults. The risk for PCV13-type disease among adults aged 65 years is much lower than it was before the pediatric program was implemented, as a result of indirect PCV13 effects . The remaining risk is a function of each individual patients risk of exposure to PCV13 serotypes and the influence of underlying medical conditions on the patients risk of developing pneumococcal disease if exposure occurs.
• The following adults aged 65 years are potentially at increased risk of exposure to PCV13 serotypes and might attain higher than average benefit from PCV13 vaccination, and providers/practices caring for many patients in these groups may consider regularly offering PCV13 to their patients aged 65 years who have not previously received PCV13:
• Persons residing in nursing homes or other long-term care facilities
• Persons residing in settings with low pediatric PCV13 uptake
• Persons traveling to settings with no pediatric PCV13 program

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.

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How Many Doses Of Ppsv23 Can An Adult Get In A Lifetime Who/when

CDC recommends some adults receive up to 3 doses of PPSV23 in a lifetime. Adults who have immunocompromising conditions should receive two doses of PPSV23, given 5 years apart, before age 65 years. Those adults should then receive a third dose of PPSV23 at or after 65 years, as long as its been at least 5 years since the most recent dose.

Medicare Coverage For The Pneumonia Shot

Part B of Original Medicare does cover the pneumonia vaccine, but there are certain limitations, according to Medicare.gov:

• Medicare Part B covers one shot. Anybody who is enrolled in Part B is entitled to a dose of pneumonia vaccine without having to pay for it if your health-care provider accepts Medicare assignment.
• Under certain circumstances, a doctor may prescribe a second shot of a different typeat least one year after the first dose. Part B may also cover this second dose.
• In either situation described above, you typically wont have out-of-pocket costs as a Part B beneficiary.

In some cases, a doctor may recommend more doses than the amount that Part B pays for. For example, a doctor may suggest a second dose of the PPSV23 vaccine. In this case, its possible that a Medicare Supplement or Medicare Advantage plan will provide coverage. Otherwise, you might have to pay for these additional services out of pocket. If the cost is a concern, its a good idea to contact Medicare or your Medicare plan to learn how these additional services will be covered or if they will be covered at all.

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How Long Does A Pneumonia Shot Last

Streptococcus pneumoniaevaccinepneumoniaStreptococcus pneumoniae

• Younger than 2 years old: four shots
• 65 years old or older: two shots, which will last you the rest of your life
• Between 2 and 64 years old: between one and three shots if you have certain immune system disorders or if youre a smoker

Other Types Of Pneumococcal Disease

Pneumonia vaccines protect against pneumococcal infections in other parts of the body. These infections include:

Otitis media

• What is it: An infection in the middle part of the ear.

• Symptoms: Fever, ear pain, and decreased hearing

• Who gets it: In the U.S., over 5 million children get it each year. Pneumococcus is a common cause of ear infections. It is found in up to 30% of samples of middle ear fluid.

Sinusitis

• What is it: A sinus infection, which is often first caused by a virus. Later, a bacterial infection can set in, causing worsening or ongoing symptoms.

• Symptoms: Pain and pressure around the eyes and nose, fever, drainage, and congestion

• Who gets it: Sinus infections are more common in adults than in children. Pneumococcus is a common cause and may contribute to up to 35% of sinus infections.

Meningitis

• What is it: An infection of the leptomeninges, or the tissue surrounding the brain and spinal cord. Meningitis can be life-threatening, so getting immediate treatment is important.

• Symptoms: Fever, confusion, headache, and neck stiffness

• Who gets it: Pneumococcal meningitis usually occurs in very young children and older adults. In the U.S., pneumococcus is the most common cause of bacterial meningitis in children under age 5.

Bacteremia

These infections can also be caused by other bacteria, viruses, and fungi. Pneumococcus, the pneumococcal vaccines, is only one cause.

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How Did Cdc Make The Decision To Recommend Pcv13 For Adults

CDC sets the adult immunization schedule based on recommendations from the Advisory Committee on Immunization Practices . ACIP used the Grading of Recommendations, Assessment, Development, and Evaluation approach or Evidence to Recommendations framework to evaluate evidence for PCV13 vaccination recommendations:

• Evidence to Recommendations for PCV13 use among adults 65 years old

How To Learn More About Medicare Coverage For Pneumonia Vaccines And Other Preventative Services

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• To communicate with me by phone or email, use one of the options below.
• Use the Compare Plans Now button on this page to get more information about Medicare insurance in your local area.

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Select Safety Information For Pneumovax 23

Do not administer PNEUMOVAX®23 to individuals with a history of a hypersensitivity reaction to any component of the vaccine.

Defer vaccination with PNEUMOVAX 23 in persons with moderate or severe acute illness.

Use caution and appropriate care in administering PNEUMOVAX 23 to individuals with severely compromised cardiovascular and/or pulmonary function in whom a systemic reaction would pose a significant risk.

Available human data from clinical trials of PNEUMOVAX 23 in pregnancy have not established the presence or absence of a vaccine-associated risk.

Since elderly individuals may not tolerate medical interventions as well as younger individuals, a higher frequency and/or a greater severity of reactions in some older individuals cannot be ruled out.

Persons who are immunocompromised, including persons receiving immunosuppressive therapy, may have a diminished immune response to PNEUMOVAX 23.

PNEUMOVAX 23 may not be effective in preventing pneumococcal meningitis in patients who have chronic cerebrospinal fluid leakage resulting from congenital lesions, skull fractures, or neurosurgical procedures.

For subjects aged 65 years or older in a clinical study, systemic adverse reactions which were determined by the investigator to be vaccine-related were higher following revaccination than following initial vaccination.

Vaccination with PNEUMOVAX 23 may not offer 100% protection from pneumococcal infection.

Can You Get The Pneumonia Vaccine & The Influenza Vaccine

With flu season here, well also note that you can get the influenza vaccine and either pneumococcal vaccine at the same time. At-risk adults and seniors should always get the influenza vaccine annually, as the flu can further increase risk of contracting pneumococcal disease. However, while you do need the influenza vaccine once a year, you dont need the pneumococcal vaccine annually. In fact, all adults 65 years or older should only receive one dose of PPSV23.

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Even Healthy People Need Vaccines

Many people still think of immunizations are for children they just don’t think of getting these, or they think, “Why should I do that if I’m healthy?”

There are other barriers to getting vaccines among adults, which were outlined in an article published by The American Journal of Medicine.

This article reported that self-reported immunization rates for tetanus, influenza and pneumococcal vaccines were lower than the national guideline goal rates. Common consumer-reported barriers included:

• Lack of physician recommendations
• Incorrect assumptions

Surveyed health care providers suggested additional barriers facing patients include:

• Fear of needles
• Perceived side effects
• Lack of insurance coverage

To increase immunization rates, it’s important to overcome these barriers, such as the widespread myth that vaccines are unsafe and commonly cause serious side effects.

Vaccines have minimal risks and are generally very safe

The risks for vaccines among people age 65 and older are the same as any population, aside from the possibility of less effectiveness with age.

Serious complications are very rare for most patients, the benefits significantly outweigh the risks involved.

The influenza vaccine is made with completely dead forms of the influenza virus, and there is no scientific way you can get the flu from the vaccine. This vaccine is generally safe for all patients over six months of age.

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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How Often Do I Need To Get The Pneumonia Vaccine

The pneumonia vaccine also known as the pneumococcal vaccine offers protection against several strains of bacteria that can cause pneumonia. There are two types of the vaccine, one of which is specifically designed for adults over the age of 65 and anyone particularly high-risk because of a long-term health condition. The other vaccine Prevnar 13 is available in our stores for adults aged 18 and over.*

Most adults getting the pneumonia vaccine will only need to get it once. Others who are high risk may need to get booster jabs every few years.

If youve never had the pneumonia vaccine, and you think you could benefit, you should check to see if youre eligible for it on the NHS. If not, you can book yours with us and have it in your local LloydsPharmacy.

Medical Conditions Resulting In High Risk Of Ipd

Table 1: Medical Conditions Resulting in High risk of IPD

Non-immunocompromising conditions

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.

Disease distribution

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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If I Inadvertently Administer Ppsv23 Less Than 8 Weeks After Pcv13 Do I Need To Repeat The Dose Of Either Vaccine

No, you do not need to repeat any doses. PPSV23 that follows PCV13 at less than 8 weeks may increase risk for localized reaction at the injection site, but remains a valid vaccination and you should not repeat it. The PCV13 dose also remains valid and you should not repeat it either. Never administer PPSV23 and PCV13 during the same visit.

How Many Doses Of Pcv13 Can An Adult Get In A Lifetime Who/when

CDC recommends adults receive 1 dose of PCV13, if indicated and if they have not received PCV13 previously . In addition, adults age 65 or older who do not have an immunocompromising condition, cerebrospinal fluid leak, or cochlear implant can choose to receive PCV13 based on shared clinical decision-making. However, if an adult received a dose of PCV13 prior to turning 65 years of age , they should not receive a dose of PCV13 when they turn 65.

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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