Why Should More Canadian Seniors Get Vaccinated For Pneumonia
This article was published more than 2 years ago. Some information may no longer be current.
The question
I recently turned 65 and went to my family doctor for a checkup. She said I should get a vaccination to protect me from pneumonia. I consider myself to be a relatively fit senior. Why would I need a pneumonia shot?
The answer
Although you may feel and look perfectly fit, your immune system becomes less efficient as you grow older. That means you become increasingly susceptible to infection from Streptococcus pneumoniae, bacteria that normally live in your body.
This type of bacteria can exist in the nose and throat without causing any ill effects most of the time. But among susceptible individuals, the germs can invade the lower parts of the lung, resulting in pneumonia and difficulty breathing. The illness often leads to hospitalization and may be deadly.
The infection, which causes most bacterial pneumonia cases, is preventable with a vaccination. The Public Health Agency of Canada urges everyone older than 65 to get a pneumonia shot and it has set a national target of inoculating 80 per cent of people within this age group.
It also recommends that young children get a similar vaccine because their immature immune systems make them vulnerable to catching the lung infection.
Pneumonia not only ravages the body it can undermine mental health, too.
A common scenario is that pneumonia precipitates another major health problem, Leis says.
Indication For Pneumovax 23
PNEUMOVAX®23 is a vaccine indicated for active immunization for the prevention of pneumococcal disease caused by the 23 serotypes contained in the vaccine .
PNEUMOVAX 23 is approved for use in persons 50 years of age or older and persons aged 2 years who are at increased risk for pneumococcal disease.
PNEUMOVAX 23 will not prevent disease caused by capsular types of pneumococcus other than those contained in the vaccine.
Who Needs The Pneumococcal Vaccine
The Centers for Disease Control and Prevention recommends the PPSV23 vaccine for all adults 65 years or older as well as adults 19 years or older with certain medical conditions that could put them at greater risk of infection. The PCV13 vaccine, on the other hand, should be a shared decision between the patient and clinician due to additional medical considerations.
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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.
Is The New Vaccination Regimen Easier For Patients
The change has given clinicians more flexibility in how we discuss vaccinations. We can prioritize time in the office for the most high-yield disease prevention. For patients, it may be confusing. Its more difficult to grasp vaccination of another group having such an enormous impact on a different demographic. We need to be more straightforward with patients, and we should be celebrating this as vaccination success.
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The 5 Vaccines Every Person Over Age 65 Should Consider
Vaccines are not just a childhood past time. They play an important role in protecting you in every phase of life. And they become particularly important during the elder years when risks to certain diseases climb higher.
For older patients in assisted living or those in larger, more populated care settings, vaccinations are even more important, as exposure risk to communicable diseases like COVID-19, the flu and pneumonia are higher.
Certain vaccines are proven to be safe and very effective in preventing several diseases that can have very serious implications for aging populations.
AdventHealth explains how five important vaccines can help keep people age 65 and older as healthy and vibrant as possible.
Who Needs A Pneumococcal Vaccination
The pneumococcal vaccine is available in Scotland for all people aged 65 years and over.
It may also be available if you’re under 65 and fall under one of the following risk groups, or have one of the following serious medical conditions:
- problems with the spleen, either because the spleen has been removed or doesn’t work properly
- chronic respiratory diseases, including chronic obstructive pulmonary disease , chronic bronchitis, and emphysema
- serious heart conditions
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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
| Age at presentation for immunization | Number of doses of Pneu-C-7, Pneu-C-10 or Pneu-C-13 previously received |
|---|
Persons With Chronic Diseases
Refer to Immunization of Persons with Chronic Diseases in Part 3 for additional information about vaccination of people with chronic diseases.
Asplenia or hyposplenia
Hyposplenic or asplenic individuals should receive Pneu-C-13 vaccine and Pneu-P-23 vaccine, followed by a booster dose of Pneu-P-23 vaccine. Refer to Table 3, Table 4 and Booster doses and re-immunization for additional information.
Chronic kidney disease and patients on dialysis
Individuals with chronic kidney disease should receive age appropriate pneumococcal vaccines. Children less than 18 years of age with chronic kidney failure or nephrotic syndrome, should receive Pneu-C-13 vaccine and Pneu-P-23 vaccine. Adults with chronic kidney failure should receive Pneu-P-23 vaccine. Adults with nephrotic syndrome should receive Pneu-C-13 and Pneu-P-23 vaccine. Due to the decreased immunogenicity and efficacy of Pneu-P-23 vaccine in children and adults with chronic kidney failure, 1 booster dose of Pneu-P-23 vaccine is recommended. Refer to Table 3, Table 4 and Booster doses and re-immunization for additional information.
Neurologic disorders
Chronic lung disease, including asthma
Chronic heart disease
Chronic liver disease
Endocrine and metabolic diseases
Non-malignant hematologic disorders
Cochlear implants
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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:
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.
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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.
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.
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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 38°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.
The Importance Of Receiving The Pneumococcal Vaccine
Fact: Thousands of adults are killed by the pneumococcal disease every year in the United Statesespecially adults 65 or older, individuals with chronic health concerns, and those who are immunocompromised.
Myth: Everyone knows that theres a vaccine available to prevent pneumococcal disease from wreaking havoc in compromised individuals.
There are an exceptional number of adults unaware of the pneumococcal diseases dangers and the pneumococcal vaccines existence and benefits. To remove yourself from this statistic, here are the facts:
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When Is The Vaccine Recommended
There are certain groups of people who are more vulnerable to pneumococcus. Thats why doctors give it to people over 65 years of age as well as to children under 5 years of age.
Its also prescribed in immunocompromised persons or in those with chronic diseases . Smokers are another risk group that should get this vaccine.
As an article in Vaccines explains, each immunization has its own indications. Specialists usually indicate Pneumococcal conjugate in the following cases:
- Children under 2 years of age. Doctors administer in four different doses at 2, 4, and 6 months of age.
- Children older than 2 years who have certain health issues.
In the case of adults over 65 years of age, the choice is complex. In general, doctors prefer polysaccharides. What you must keep in mind is that neither of the two should be administered if theres already been an allergic reaction to either of them. Pregnant women shouldnt get it either.
What Is The Pneumonia Vaccine
Pneumonia is a lung infection. What happens is that the alveoli fill with fluid or pus. This is why the person cant breathe properly. It usually causes a cough, fever and general malaise, among other symptoms. The problem is that this condition can become severely complicated, sometimes even lethal.
According to a publication by the Centers for Disease Control and Prevention, almost 50,000 people die annually from pneumonia in the United States alone. In addition, about one million receive medical care for this health issue.
Certain groups of people are at higher risk for pneumonia or a more severe form of pneumonia. First and foremost are adults over the age of 65 and children under the age of 5.
Those with chronic diseases, such as diabetes or high blood pressure, are another risk group. The same applies to immunocompromised persons. Smokers are also more at risk, as their lungs are vulnerable.
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Is Cost A Factor In Deciding Whether Or Not To Give A Vaccination
Yes, the CDC wrote extensively about the decreasing cost-benefit of PCV-13. Essentially, vaccination of all older adults with PCV13 is no longer cost effective as rates of those serotypes continue to decrease. Universal PCV13 was not considered a judicious use of healthcare resources. Its hard to put money amounts on the benefit of a vaccine its more of a way to compare cost and efficacy with other interventions such as PPSV23.
This Infectious Disease Can Pose A Serious Health Risk For Those Age 65 And Older But Two Vaccines Can Offer Sound Protection
One of the leading health dangers for older adults is pneumonia. It is the most common cause of hospital admissions after childbirth. In fact, adults age 65 and older have a higher risk of death from pneumonia hospitalization than any other reason.
Pneumonia is an infection of the lungs by bacteria, viruses, or other microbes. Most cases are caused by the bacteria Streptococcus pneumoniae, Mycoplasma pneumonia, Chlamydia pneumoniae, Chlamydia psittaci, and Legionella pneumophila. A similar inflammation of the lung, called pneumonitis, can be caused by an inhaled chemical and is more common in people who have had strokes and have difficulty swallowing. A physical exam, chest x-ray, and blood test can confirm a diagnosis.
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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:
- cough
- 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.
Who Should Have The Pneumococcal Vaccine
Anyone can get a pneumococcal infection. But some people are at higher risk of serious illness, so it’s recommended they’re given the pneumococcal vaccination on the NHS.
These include:
- babies
- adults aged 65 or over
- children and adults with certain long-term health conditions, such as a serious heart or kidney condition
Babies are offered 2 doses of pneumococcal vaccine, at 12 weeks and at 1 year of age.
People aged 65 and over only need a single pneumococcal vaccination. This vaccine is not given annually like the flu jab.
If you have a long-term health condition you may only need a single, one-off pneumococcal vaccination, or a vaccination every 5 years, depending on your underlying health problem.
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