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.
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.
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.
The Pneumonia Vaccine Explained
While pneumonia is usually mild, it can have deadly consequences for portions of the population, especially people over the age of 65. In fact, Streptococcus pneumoniae, the bacteria that causes pneumococcal disease, is the No. 1 cause of pneumonia worldwide.
The vaccine indirectly protects adults by stopping children from spreading the bacteria
“But this bacteria doesn’t just cause pneumonia. It’s a nasty human pathogen that can invade the brain and bloodstream, leading to ear infections, sinus infections, even meningitis,” says Dr. Michael Ben-Aderet, associate medical director of Hospital Epidemiology at Cedars-Sinai.
“It can make people very sick, and it’s a key cause of death among the elderly.”
In 2017, an estimated 3,600 people died from invasive pneumococcal disease in the U.S. alone.
What Are The Symptoms Of Pneumonia
The signs and symptoms of pneumonia can range from mild to severe. The symptoms depend on the type of germ that caused the infection, your age and overall health. Mild signs and symptoms of pneumonia are often similar the symptoms of a cold or flu, but the effects of pneumonia last longer.
Signs and symptoms of pneumonia may include:
- Chest pain when you breathe or cough
- Confusion or changes in mental awareness
- Cough, which may produce phlegm
- Fever, sweating and shaking chills
- Lower-than-normal body temperature
- Nausea, vomiting or diarrhea
- Shortness of breath
Newborns and infants may not show any sign or symptoms of the infection. However, they may vomit, have a fever, cough, be restless or tired, or have difficulty breathing and eating.
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Adults At High Risk Of Ipd
Adults with immunocompromising conditions resulting in high risk of IPD, except HSCT, should receive 1 dose of Pneu-C-13 vaccine followed at least 8 weeks later by 1 dose of Pneu-P-23 vaccine, if not previously received. The dose of Pneu-C-13 vaccine should be administered at least 1 year after any previous dose of Pneu-P-23 vaccine. Refer to Immunocompromised persons for information about immunization of HSCT recipients.
Immunocompetent adults with conditions or lifestyle factors resulting in high risk of IPD should receive 1 dose of Pneu-P-23 vaccine, if not previously received. One dose of Pneu-P-23 vaccine is also recommended for all adults who are residents of long-term care facilities and should be considered for individuals who use illicit drugs.
Some experts also suggest a dose of Pneu-C-13 vaccine, followed by Pneu-P-23 vaccine, for immunocompetent adults with conditions resulting in high risk of IPD as this may theoretically improve antibody response and immunologic memory. However, Pneu-P-23 vaccine is the vaccine of choice for these individuals, and if only one vaccine can be provided, it should be Pneu-P-23 vaccine, because of the greater number of serotypes included in the vaccine.
Adults at highest risk of IPD should also receive 1 booster dose of Pneu-P-23 vaccine refer to Booster doses and re-immunization.
Table 4 – provides recommended schedules for adult immunization with pneumococcal vaccines.
Who Needs One Or Two Pneumonia Vaccines
There are two pneumococcal vaccines, each working in a different way to maximize protection. PPSV23 protects against 23 strains of pneumococcal bacteria. Those 23 strains are about 90- to 95-plus percent of the strains that cause pneumonia in humans, Poland explains. PCV13, on the other hand, is a conjugate vaccine that protects against 13 strains of pneumococcal bacteria. PCV13 induces immunologic memory, he says. Your body will remember that it has encountered an antigen 20 years from now and develop antibodies to fight it off.
In order to get the best protection against all strains of bacteria that cause pneumonia, the CDC has long recommended that everyone 65 or older receive both vaccines: PCV13 , followed by the pneumococcal polysaccharide vaccine at a later visit. But the agency is now saying that PCV13 may not be necessary for healthy people 65 and older, suggesting that the decision be left up to patients and their physicians as to whether that extra skin prick is appropriate.
“Anyone who reaches the age of 65 and is in any way immunocompromised or has any of the listed indications for pneumococcal vaccine because they’re in a high-risk group for example, if they have diabetes, heart disease or lung disease, or are a smoker should continue to get both vaccines, says Schaffner.
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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.
People With Medical Risk Factors
In addition to the 3 doses of 13vPCV routinely recommended for healthy non-Indigenous children < 5 years of age, children 12 months of age with risk conditions for pneumococcal disease are recommended to receive:
- An additional dose of at 6 months of age
- a dose of at 4 years of age
- a 2nd dose of at least 5 years after the 1st dose of 23vPPV
This is because of the higher disease burden and the possibility of lower antibody responses in these children.2-4
Aboriginal and Torres Strait Islander children diagnosed with risk conditions at 12 months of age who live in the Northern Territory, Queensland, South Australia and Western Australia already receive these extra doses as part of their routine schedule.
Any child aged 6 to 11 months with a newly identified risk condition who has not received an additional dose of 13vPCV at 6 months of age should receive this dose at diagnosis. The exception is children who have received a haematopoietic stem cell transplant these children are recommended to receive 3 doses of 13vPCV after transplantation, followed by 2 doses of 23vPPV
All children and adults with newly identified risk conditions are recommended to receive:
- 1 dose of at diagnosis (at least 2 months after any previous doses of 13vPCV
- or at 4 years of age whichever is later
- a 2nd dose of 23vPPV at least 5 years later
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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.
What If It Is Not Clear What A Person’s Vaccination History Is
When indicated, vaccines should be administered to patients with unknown vaccination status. All residents of nursing homes and other long-term care facilities should have their vaccination status assessed and documented.
How long must a person wait to receive other vaccinations?
Inactivated influenza vaccine and tetanusvaccines may be given at the same time as or at any time before or after a dose of pneumococcus vaccine. There are no requirements to wait between the doses of these or any other inactivated vaccines.
Vaccination of children recommended
In July 2000, the American Academy of Pediatrics and the CDC jointly recommended childhood pneumococcal immunization, since pneumococcal infections are the most common invasive bacterial infections in children in the United States.
“The pneumococcal conjugate vaccine, PCV13 or Prevnar 13, is currently recommended for all children younger than 5 years of age, all adults 65 years or older, and persons 6 through 64 years of age with certain medical conditions,” according to the 2014 AAP/CDC guidelines. “Pneumovax is a 23-valent pneumococcal polysaccharide vaccine that is currently recommended for use in all adults 65 years of age or older and for persons who are 2 years and older and at high risk for pneumococcal disease . PPSV23 is also recommended for use in adults 19 through 64 years of age who smoke cigarettes or who have asthma.”
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Groups At Risk Of Ipd
People who are immunocompromised and unable to mount an adequate immune response to pneumococcal capsular antigens have the highest risk of IPD.2,4,34 This includes people with asplenia.
Greater risk and/or severity of IPD
- excessive alcohol consumption
- certain non-immunocompromising chronic medical conditions2,34,42,43
Indigenous populations in developed countries, including Aboriginal and Torres Strait Islander people in Australia, have a disproportionately high burden of IPD
Young children and elderly people have the highest incidence of invasive pneumococcal disease .37,38,45 Disease burden is also disproportionately high in Aboriginal and Torres Strait Islander people.1,2
Pneumococcal Disease In Children
In children, the most common manifestation is bacteraemia without focus. This accounts for approximately 70% of IPD, followed by pneumonia with bacteraemia.
Meningitis is the least common but most severe category of IPD
Acute otitis media is the most common non-invasive manifestation of pneumococcal disease in children. Streptococcus pneumoniae is detected in 2855% of middle ear aspirates from children with acute otitis media.34,38,39
Pneumococcal disease in adults
In adults, pneumonia with bacteraemia is the most common manifestation of IPD
- more than one-third of all community-acquired pneumonia
- up to half of hospitalised pneumonia in adults
However, it is difficult to accurately determine the proportion attributable to pneumococci in cases of non-bacteraemic pneumonia.
Symptoms of pneumonia include:
- chest pain
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Pneumonia Vaccine Side Effects
Most people who get a pneumococcal vaccine do not experience many side effects. While theres always a chance of side effects for any medication, the pneumonia vaccine side effects are usually mild and go away on their own after a few days, with serious reactions being rare.
Pneumococcal conjugate vaccineMild problems following pneumococcal conjugate vaccination can include:
- Reactions at the injection site
Booster Doses Of Pneumococcal Vaccine
If you’re at increased risk of a pneumococcal infection, you’ll be given a single dose of the PPV vaccine.
But if your spleen does not work properly or you have a chronic kidney condition, you may need booster doses of PPV every 5 years.
This is because your levels of antibodies against the infection decrease over time.
Your GP surgery will advise you on whether you’ll need a booster dose.
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Questions To Ask Your Doctor
- When should I make an appointment to get each type of pneumococcal vaccine?
- Should I still get the vaccines if Ive recently had pneumonia?
- Should I wait to turn 65 before I get each dose of pneumococcal vaccines?
- If I have a negative reaction to one type of pneumococcal vaccine, am I likely to have that same reaction to the other?
Funding was provided for these pneumococcal resources through an unrestricted grant from Pfizer Independent Grant for Learning and Change .
Who Should Get The Pneumonia Vaccine
The pneumonia vaccine recommendations from the CDC are for all children younger than 2 years old and all adults 65 years or older.
In other situations, children and adults should also get pneumococcal vaccines such as people with weakened immune systems, people who smoke, heavy drinkers, or people getting over surgery or a severe illness.
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Patients In Health Care Institutions
Residents of long-term care facilities should receive Pneu-P-23 vaccine. Refer to Recommendations for Use for information about pneumococcal vaccination of individuals at increased risk of IPD. Refer to Immunization of Patients in Health Care Institutions in Part 3 for additional information about vaccination of patients in health care institutions.
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.
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Interchangeability Of 10vpcv And 13vpcv
There are no specific data on the interchangeability of 10vPCV and 13vPCV. It is preferable to complete a primary course of pneumococcal conjugate vaccine with the same formulation. However, if a child started their vaccination course with 10vPCV , it is acceptable to complete the course with 13vPCV
The only absolute contraindications to pneumococcal vaccines are:
- anaphylaxis after a previous dose of any pneumococcal vaccine
- anaphylaxis after any component of a pneumococcal vaccine
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 .
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Who Else Should Get The Pneumococcal Vaccination
For adults, the Centers for Disease Control and Prevention recommends pneumococcal vaccination for:
Anyone 65 years of age and older
Adults with any of these health conditions:
Chronic illnesses such as lung, heart, liver or kidney disease asthma diabetes or alcoholism
Conditions that weaken the immune system cochlear implants or cerebro-spinal fluid leaks asplenia
Adults who smoke cigarettes
How Does The Pneumonia Vaccine Work
There are currently two vaccines administered in the United States:
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