Flu And Pneumonia Shots Offer Double Protection For Seniors
Excerpt: Flu and pneumonia shots for older adults are especially important this fall to protect their own health, the health of others and to keep the Canadian healthcare system from becoming overwhelmed in a pandemic. The high-dose flu vaccine is an option to consider because it offers seniors stronger protection. Getting a pneumonia shot is also recommended to reduce the risk of pneumonia, an important cause of hospital emergency visits.
To breathe easier this fall and winter, it is especially important for older adults to get vaccinated against both the flu and pneumonia for their own health and the health of others.
Health authorities are urging Canadians to get a flu shot this fall to avoid a twindemic, in which large numbers of people become seriously ill, or hospitalized, as influenza and COVID-19 circulate at the same time,* says the B.C. Centre for Disease Control. While the flu shot doesnt directly protect people against COVID-19, its vital for older adults and those with high-risk conditions to protect themselves against the flu since hospitals and other healthcare facilities could become overwhelmed if they need to treat both flu and COVID-19 patients.*
Being vaccinated for the flu could also help reduce unnecessary testing for COVID-19* since many symptoms of both illnessessuch as fever, cough, shortness of breath, sore throat, runny or stuffed nose, and muscle achesare similar,* according to Mayo Clinic.
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 Are The Important Side Effects Of Pneumovax 23
Common side effects of pneumococcal vaccine are:
- myalgia .
Clinical Trials Experience
Because clinical trials are conducted under widelyvarying conditions, adverse reaction rates observed in the clinical trials of avaccine cannot be directly compared to rates in the clinical trials of anothervaccine and may not reflect the rates observed in practice.
- In a randomized, double-blind, placebo-controlledcrossover clinical trial, subjects were enrolled in four different cohortsdefined by age and vaccination status .
- Subjects in each cohort were randomizedto receive intramuscular injections of Pneumovax 23 followed by placebo , or placebo followed by Pneumovax 23, at 30-day intervals.
- The safety of an initial vaccination was comparedto revaccination with Pneumovax 23 for 14 days following each vaccination.
- All 1008 subjects received placebo injections.
- Initial vaccination was evaluated in a total of 444subjects .
- Revaccination was evaluated in 564 subjects .
Serious Adverse Experiences
In this study, 10 subjects had serious adverseexperiences within 14 days of vaccination: 6 who received Pneumovax 23 and 4who received placebo. Serious adverse experiences within 14 days afterPneumovax 23 included
In this clinical study an increased rate of localreactions was observed with revaccination at 3-5 years following initialvaccination.
The most common systemicadverse reactions reported after Pneumovax 23 were as follows:
- asthenia/fatigue,
- myalgia and
- headache.
Post-Marketing Experience
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Who Should Not Get These Vaccines
Because of age or health conditions, some people should not get certain vaccines or should wait before getting them. Read the guidelines below specific to pneumococcal vaccines and ask your or your childs doctor for more information.
Children younger than 2 years old should not get PPSV23. In addition, tell the person who is giving you or your child a pneumococcal conjugate vaccine if:
You or your child have had a life-threatening allergic reaction or have a severe allergy.
- Anyone who has had a life-threatening allergic reaction to any of the following should not get PCV13:
- A shot of this vaccine
- An earlier pneumococcal conjugate vaccine called PCV7
- Any vaccine containing diphtheria toxoid
You or your child are not feeling well.
- People who have a mild illness, such as a cold, can probably get vaccinated. People who have a more serious illness should probably wait until they recover. Your or your childs doctor can advise you.
How Effective Is Each Vaccine
Vaccines help protect against disease, but no vaccine is 100% effective.
Studies show that at least one dose of Prevnar 13 protects 80% of babies from serious pneumococcal infections, 75% of adults age 65 and older from invasive pneumococcal disease , and 45% of adults age 65 and older from pneumococcal pneumonia.
Studies show that one dose of Pneumovax 23 protects 50% to 85% of healthy adults against invasive pneumococcal disease.
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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.
How Does It Work
Prevnar 20 is a conjugate vaccine. This means that it contains pieces of sugar-like substances called polysaccharides that typically coat the bacteria but also hide it from our immune system. The vaccine uses only a certain portion of the bacteria not the bacteria itself so its unable to cause an infection.
This conjugate vaccine uses 20 slightly different polysaccharides that are specific to the 20 serotypes and attaches them to proteins that our immune systems can recognize. If the bacteria enters the body after the vaccination is administered, the immune system can recognize the polysaccharide molecule and release antibodies to fight the bacteria before it causes an infection.
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Updates To Pneumonia Vaccine Recommendations For Adults Over 65
There are two types of vaccines against pneumococcal disease: pneumococcal conjugate vaccine and pneumococcal polysaccharide vaccine . PCV 13 is available under the brand name Prevnar 13 and PPSV23 is sold as the brand Pneumovax 23. For all adults aged 65 years or older, CDC used to recommend a routine series of Prevnar 13 and Pneumovax 23 vaccines. However, due to the decline of pneumococcal disease among seniors as a result of vaccinations, guidelines have changed.
In June 2019, the Advisory Committee on Immunization Practices decided that for healthy adults aged 65 or older, the vaccine may not be necessary. ACIP now recommends that patients have a conversation with their doctor to decide whether to get Prevnar 13. However, older adults who have a high risk for pneumococcal disease should still receive both Prevnar 13 and Pneumovax 23. Additionally, Pneumovax 23 is still recommended for all adults over age 65.
| Old Recommendation for Older Adults | New Recommendation for Older Adults |
| For all adults 65 years old or older*:Administer 1 dose of PCV 13 first, and give 1 dose of PPSV23 at least 1 year later | For adults 65 years old or older who do not have immunocompromising condition*:Administer 1 dose of PPSV23For adults 65 years old or older with an immunocompromising condition, cochlear implant, or cerebrospinal fluid leak*:Administer PCV13 first, and give PPSV23 at least 8 weeks |
* For more information, visit CDC website at
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.
According to Pfizer, ACIP is expected to meet in to discuss updated recommendations on the use of pneumococcal vaccines in adults.
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Should Adults Over 65 Get Prevnar 13
PCV13 is still a safe and effective vaccine, especially if you have medical conditions or live in a place with high risk of exposure to pneumococcal strains, such as a nursing home or long-term care facility. Doctors and their patients need to consider both the exposure risk and personal risks for each patient to decide whether Prevnar 13 is necessary. If you have questions about either vaccine, talk to your doctor or pharmacist.
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According to the CDC, only about 70% of adults aged 65 and older ever receive a pneumococcal vaccination, either PCV13 or PPSV23. Hopefully, the new recommendations will encourage more people to get vaccinated since healthy adults now only need a single dose rather than two doses.
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.
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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Side Effects Of The Pneumococcal Vaccine
Like most vaccines, the childhood and adult versions of the pneumococcal vaccine can sometimes cause mild side effects.
These include:
- 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 .
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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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.
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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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 |
|---|
Who Should Not Get The Influenza Vaccine
Speak with a health care provider if you:
- Have had a life-threatening reaction to a previous dose of influenza vaccine, or any part of the vaccine. People with egg allergies can be safely immunized with the influenza vaccine
- Have had severe oculo-respiratory syndrome after getting an influenza vaccine
- Are receiving a checkpoint inhibitor to treat cancer. This may affect when you should get the vaccine
- Developed Guillain-Barré Syndrome within 8 weeks of getting an influenza vaccine without another cause being identified
GBS is a rare condition that can result in weakness and paralysis of the body’s muscles. It most commonly occurs after infections. In rare cases GBS can also occur after some vaccines. GBS may be associated with influenza vaccine in about 1 per million recipients.
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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:
How Can Influenza Be Prevented
You can reduce the risk of getting influenza or spreading it to others by:
- Washing your hands regularly
- Cleaning and disinfecting objects and surfaces that people touch
- Promptly disposing of used tissues in the waste basket or garbage
- Coughing and sneezing into your shirt sleeve rather than your hands
- Staying home when you are ill
- Getting an influenza vaccine
Getting an influenza vaccine can help prevent you from getting sick with influenza and from spreading it to others.
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