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.
How Do I We Get The Vaccine
In Canada, all provinces and territories provide the pneumococcal conjugate vaccine, starting at 2 months of age. While the exact schedule will depend on where you live, usually two shots are given between 2 and 11 months of age and a booster at 12-15 months. Children at high risk of disease are given three shots , as well as the booster.
Unvaccinated children between 15 months and 5 years old should also get the vaccine. Your doctor or public health unit can tell you the number of shots your child will need and when.
All unvaccinated children and adolescents who are at high risk of serious infection should receive both the conjugate and the polysaccharide vaccine. The polysaccharide vaccine is at given at age 2 or later, with a booster 5 years after the first.
Immunizations Are Even More Important As We Age
As we age, the immune system declines in its ability to fight off infections, which makes people ages 65 and older more vulnerable to diseases like influenza, COVID-19, pneumonia, and shingles.
People of this age group are also at a higher risk for serious complications related to these diseases compared to younger populations. The flu in a 40-year-old is very different than in an 80-year-old.
According to our experts, while a 40-year-old might be in bed for a few days nursing the flu with rest, an 80-year-old is more likely to experience more serious symptoms that could lead to hospitalization, and in the most serious and unfortunate circumstances, can even be a cause of death.
These are five important vaccines to consider if you are age 65 or older:
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More Information On Side Effects
Reactions listed under âpossible side effectsâ or âadverse eventsâ on vaccine product information sheets may not all be directly linked to the vaccine. See Vaccine side effects and adverse reactions for more information on why this is the case.
If you are concerned about any reactions that occur after vaccination, consult your doctor. In the UK you can report suspected vaccine side effects to the Medicines and Healthcare products Regulatory Agency through the Yellow Card Scheme
The Different Types Of Pneumococcal Vaccine
The type of pneumococcal vaccine you’re given depends on your age and health. There are 2 types.
Pneumococcal conjugate vaccine is used to vaccinate children under 2 years old as part of the NHS vaccination schedule. It’s known by the brand name Prevenar 13.
Children at risk of pneumococcal infections can have the PPV vaccine from the age of 2 years onwards. The PPV vaccine is not very effective in children under the age of 2.
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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
Haemophilus Influenzae Type B Vaccination
Special situations
- Anatomical or functional asplenia : 1 dose if previously did not receive Hib if elective splenectomy, 1 dose, preferably at least 14 days before splenectomy
- Hematopoietic stem cell transplant : 3-dose series 4 weeks apart starting 612 months after successful transplant, regardless of Hib vaccination history
Routine vaccination
- Not at risk but want protection from hepatitis A: 2-dose series HepA or 3-dose series HepA-HepB
Special situations
- At risk for hepatitis A virus infection: 2-dose series HepA or 3-dose series HepA-HepB as above
- Chronic liver disease
- HIV infection
Routine vaccination
- Not at risk but want protection from hepatitis B: 2- or 3-dose series or 3-dose series HepA-HepB
Special situations
- At risk for hepatitis B virus infection: 2-dose or 3-dose series or 3-dose series HepA-HepB as above
- Chronic liver disease
- HIV infection
- Sexual exposure risk
- Current or recent injection drug use
- Percutaneous or mucosal risk for exposure to blood
- Incarcerated persons
- Travel in countries with high or intermediate endemic hepatitis B
- Pregnancy if at risk for infection or severe outcome from infection during pregnancy. Heplisav-B not currently recommended due to lack of safety data in pregnant women
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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 It True That More Than One Type Of Infection Can Cause Meningitis
Yes. Everyone has heard it on the news the story of a local student infected with meningitis. Such a report inevitably results in many questions and a great amount of concern and even fear among families with children in the affected school.
There are some important considerations when this happens. First, it is important to remember that meningitis refers to an infection that has reached the lining of the brain and spinal cord. Second, it can be caused by viruses or bacteria .
Viral meningitis, the most common type of meningitis, is often less severe than bacterial meningitis. Vaccine-preventable diseases that can cause viral meningitis include measles, mumps, chickenpox and influenza.
Most, but not all, cases of bacterial meningitis can be prevented by vaccination. The bacteria most often associated with meningitis include meningococcus, pneumococcus, and Haemophilus influenzae type B . Fortunately, by the age of 2, most children are fully immunized against pneumococcus and Hib and most adolescents are protected against meningococcus.
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What Are The Side Effects Of The Pneumococcal Vaccine
After receiving the pneumococcal vaccine, children commonly will have pain or swelling where the shot is given and occasionally low-grade fever. About 1 of every 100 children will develop a high fever.
Side effects from the polysaccharide version used in adults include tenderness and redness at the injection site, and about 1 of every 100 people will get a fever and experience muscle aches.
Pneumococcal Vaccine Development: A Historical Perspective
S. pneumoniae was first discovered in the late 19th century by U.S. Army physician George Sternberg and French scientist Louis Pasteur, when it was recognized as a major pathogenic cause of bacterial pneumonia . In 1902, German scientist Friedrich Neufeld discovered that antiserum containing different types of S. pneumoniaspecific antibodies caused a type-specific capsular swelling, or Quellung reaction, which allowed identification of multiple pneumococcal serotypes. Polysaccharides that were identified coursing along the exterior of the bacterium could be targeted for vaccine development. British physician Sir Almroth Wright conducted the first large clinical trial of a whole-cell pneumococcal vaccine. This trial was largely unsuccessful, bringing vaccine development to a relative halt for the next three decades .
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Discussion And Future Directions
Over the past 100 years, substantial progress has been made in the prevention of invasive pneumococcal disease. Current recommendations reflect a series of changes made over a relatively short span of time, on the basis of growing data and experience with both polysaccharide and conjugate vaccines in multiple different populations. With so many nearly simultaneous changes in vaccine strategy, it remains a challenge to appropriately attribute the source of greatest effect. It is clear that prior PCV7 vaccination strategies in children over the past 2 decades yielded substantial indirect impacts on the prevalence of adult vaccine-type pneumococcal disease, and therefore the switchover to preferential use of PCV13 in the pediatric population may be expected to yield more of the same, although that remains to be proven.
At this point, we are still inferring future benefits from data presently available. The original impetus for use of PCV13 in the elderly population was the robust immunogenicity data in this population. This fact, in conjunction with clinical trial results in immunocompromised populations, was the foundation for the present substantial shift in adult immunization practice. Although this strategy appears to be well supported by the compelling results observed in CAPiTA, with 45% efficacy in prevention of community-acquired pneumonia and 75% efficacy in prevention of invasive pneumococcal disease, there are some caveats to consider.
Tetanus Diphtheria And Pertussis Vaccination
Routine vaccination
- Previously did not receive Tdap at or after age 11 years: 1 dose Tdap, then Td or Tdap every 10 years
Special situations
- Previously did not receive primary vaccination series for tetanus, diphtheria, or pertussis: At least 1 dose Tdap followed by 1 dose Td or Tdap at least 4 weeks after Tdap and another dose Td or Tdap 612 months after last Td or Tdap Td or Tdap every 10 years thereafter
- Pregnancy: 1 dose Tdap during each pregnancy, preferably in early part of gestational weeks 2736
- Wound management: Persons with 3 or more doses of tetanus-toxoid-containing vaccine: For clean and minor wounds, administer Tdap or Td if more than 10 years since last dose of tetanus-toxoid-containing vaccine for all other wounds, administer Tdap or Td if more than 5 years since last dose of tetanus-toxoid-containing vaccine. Tdap is preferred for persons who have not previously received Tdap or whose Tdap history is unknown. If a tetanus-toxoid-containing vaccine is indicated for a pregnant woman, use Tdap. For detailed information, see www.cdc.gov/mmwr/volumes/69/wr/mm6903a5.htm
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Where Can I Find These Vaccines
Your doctors office is usually the best place to receive recommended vaccines for you or your child.
PCV13 is part of the routine childhood immunization schedule. Therefore, it is regularly available for children at:
- Pediatric and family practice offices
- Community health clinics
If your doctor does not have pneumococcal vaccines for adults, ask for a referral.
Pneumococcal vaccines may also be available for adults at:
- Pharmacies
- Health departments
- Other community locations, such as schools and religious centers
Federally funded health centers can also provide services if you do not have a regular source of health care. Locate one near youexternal icon. You can also contact your state health department to learn more about where to get pneumococcal vaccines in your community.
When receiving any vaccine, ask the provider to record the vaccine in the state or local registry, if available. This helps doctors at future encounters know what vaccines you or your child have already received.
Epidemiology And Risk Factors
Although invasive pneumococcal disease is much less prevalent than noninvasive disease, it confers significant mortality risk , and survivors can be left with significant sequelae . Furthermore, given the widespread use of empiric antibiotics and frequent lack of timely culture or urinary antigen data, the true burden of primary and invasive pneumococcal disease may be significantly underestimated .
Certain groups are at particularly high risk for invasive pneumococcal disease: young children, the elderly, and those with high-risk comorbid diseases or substance habits. The Centers for Disease Control and Preventions Active Bacterial Core Surveillance data from 2013 demonstrated increased rates of invasive pneumococcal disease in children younger than age 5 years and in adults 65 years or older .
Independent of age, the presence of other comorbid chronic conditions such as cardiovascular disease, chronic obstructive pulmonary disease , asthma, renal insufficiency, and diabetes mellitus increases the risk for invasive pneumococcal disease . Patients with common pulmonary conditions like COPD and asthma have a two- to sixfold risk for invasive pneumococcal disease compared with the general population . In addition, active smoking confers increased risk, as do alcohol and intravenous drug use .
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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.
How Can We Reduce The Number Of People Dying From Pneumonia
When we understand what risks can lead to pneumonia, we can find ways to reduce them. Furthermore, because a number of risks factors for pneumonia overlap with risk factors for other diseases, especially diarrheal diseases, interventions that target pneumonia have the additional benefit of helping to limit other diseases and saving more lives.
Vaccines against pneumonia
There are several versions of pneumococcal conjugate vaccine , which target different serotypes of S. pneumoniae the bacterium responsible for most cases of pneumonia.
The PCV vaccine is given to children younger than 24 months. According to a study by Cheryl Cohen et al. , PVC13 the currently recommended PCV vaccine version has 85% effectiveness against invasive infections caused by the specific strains the pneumococcal strainsincluded in the vaccine formulation.13
It has been estimated that if PCV13 coverage in low income countries would reach the coverage of the DTP3 vaccine, then PCV13 could prevent 399,000 child deaths and 54.6 million pneumonia episodes annually when compared with a world in which no pneumococcal vaccination was available.14 India which has the highest number of child deaths from pneumonia only introduced PCV13 in 2017 and the coverage is still very low clearly the pneumococcal vaccine still has a lot of potential.15
Another vaccine widely used to protect children against both pneumonia is the Hib vaccine.
Promoting breastfeeding
Reducing air pollution
Oxygen therapy
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Why No Shot For Pneumonia After Age 70
Dear Dr. Donohue Why does the medical profession tell us that folks over 70 do not need a pneumonia shot in the fall when they get their flu shots? Why do some say you should get the shot every year, while others say every other year, and some say every five years? Please clear up. S.M.
Answer The pneumonia shot is a vaccine for one kind of pneumonia, pneumococcal pneumonia, the kind caused by the bacterium pneumococcus . It’s a very serious kind of pneumonia, one that often proves lethal for the elderly.
The adult vaccine in use affords protection against 23 of more than 90 different strains. The name of the vaccine is Pneumovax 23. A single dose of the vaccine given to people age 65 and older is all the vaccine needed at the present time. However, if a person received the vaccine at an age younger than 65, that person does need a booster shot five years after the first shot was given.
Dear Dr. Donohue I recently read that mad cow disease and Alzheimer’s disease are a lot alike. Is there any truth to that? M.S.
Answer Mad cow disease is quite rare in North America. It’s not related to Alzheimer’s disease. It’s caused by an unusual germ called a prion a protein, a newly discovered life form. It’s an infectious disease. When humans are infected, their mental facilities fall apart somewhat rapidly.
Write Dr. Donohue at P.O. Box 536475, Orlando, Fla. 32853-6475.