What If You Never Got Prevnar 13 As A Child
Lets say you never got a vaccine for pneumococcal bacteria when you were little . Most of you will just wait until you turn 65 years old, at which time, youll get Prevnar 13 followed by Pneumovax 23 at least 1 year later.
In certain cases, the timing may be different. Your provider will be able to advise you based on your specific situation.
Enhancing Healthcare Team Outcomes
Pneumonia is a common infectious lung disease. It requires interprofessional care and the involvement of more than one subspecialty. This patient-centered approach involving a physician with a team of other health professionals, physiotherapists, respiratory therapists, nurses, pharmacists, and support groups working together for the patient plays an important role in improving the quality of care in pneumonia patients. It not only decreases the hospital admission rates but also positively affect the disease outcome. For healthy patients, the outcomes after treatment are excellent but in the elderly and those with comorbidities, the outcomes are guarded.
Urgent Advice: Contact Your Gp Or If Your Gp’s Closed Phone 111 If:
- you have a constant high temperature that lasts for more than three days
- you cough up mucus streaked with blood
- you develop rapid breathing or chest pains
- you become drowsy or confused
- you experience shortness of breath or other breathing difficulties
- your child is under three months and has a temperature of 38C or above
- your child is over 3 months and has a temperature of 39C or above
- your child is over two years of age and their symptoms persist for more than three days
You should also contact your GP if you have any of the risk factors that make you more vulnerable to developing a pneumococcal infection.
Read about the causes of pneumococcal infections for more information about these risk factors.
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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
Chronic Bronchitis Vs Copd
A chronic obstructive pulmonary disease exacerbation is another issue entirely when compared to chronic bronchitis. A COPD exacerbation is simply an acute worsening of the symptoms of COPD, such as wheezing, shortness of breath, mucus production, or coughing.
Depending on the kind of COPD a person has , these symptoms may be slightly different.
Patients with chronic bronchitis generally have more mucus production and cough, whereas people with emphysema have more shortness of breath, although either type of COPD can cause any number of these symptoms.
A COPD exacerbation may be caused by an infection , but it may also be caused by non-infectious causes such as fumes, irritants, or smoke.
The treatment for an acute COPD exacerbation is often steroids, inhalers, and antibiotics .
If you have chronic bronchitis or COPD and experience worsening of your symptoms, contact your healthcare provider. They will be able to determine the correct treatment for you.
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Persons With Inadequate Immunization Records
Children and adults lacking adequate documentation of immunization should be considered unimmunized and should be started on an immunization schedule appropriate for their age and risk factors. Pneumococcal vaccines may be given, regardless of possible previous receipt of the vaccines, as adverse events associated with repeated immunization have not been demonstrated. Refer to Immunization of Persons with Inadequate Immunization Records in Part 3 for additional information about vaccination of people with inadequate immunization records.
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.
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Factors That Predispose To Pneumococcal Infection
S. pneumoniae is a prototypic extracellular bacterial pathogen host defenses against infection rely, as noted earlier, on the interaction between antibody, complement, and phagocytic cells, specifically neutrophils. Both primary and secondary clinical conditions and underlying mechanisms may hamper the immunologic capacity of the host and predispose to pneumococcal infection . Although these risks include defects in anatomy, antibody production, complement, and phagocytes , cell-mediated abnormalities in T and natural killer cells do not figure prominently among them. These predisposing conditions do, however, include underlying liver, kidney, heart, and lung dysfunction diabetes alcoholism, and malignancies, particularly in older adults, which may invoke a more subtle constellation of predisposing risks.
Regarding antibody production in older adults, both the number of naïve T cells and B cells may decrease with advancing age,137-139 as may the subsets of IgM memory B cells proposed to respond preferentially to polysaccharide antigens.105,140-143 These perturbations and decreased responses to pneumococcal polysaccharides have been most closely related to weight loss and frailty rather than to age alone.144,145 Studies have been begun to distinguish between innate age-dependent immunosenescence and the effects of accumulated underlying disease and frailty on age-related immune dysfunction, particularly decreased responses to vaccination.
HIV Infection
Who Shouldnt Get Prevnar 20
People who have had a severe allergic reaction in the past to any of the vaccines ingredients including diphtheria protein should not receive Prevnar 20. People who are 17 years or younger also shouldnt receive this vaccine.
At this time, the FDA didnt place any other restrictions on who can receive Prevnar 20. If youre unsure if you should receive this vaccine, your healthcare provider can give you more information.
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How Is Pneumonia Treated
Treatment depends on the type of pneumonia you have. Most of the time, pneumonia is treated at home, but severe cases may be treated in the hospital. Antibiotics are used for bacterial pneumonia. Antibiotics may also speed recovery from mycoplasma pneumonia and some special cases. Most viral pneumonias dont have specific treatment. They usually get better on their own.
Other treatment may include eating well, increasing fluid intake, getting rest, oxygen therapy, pain medicine, fever control, and maybe cough-relief medicine if cough is severe.
How Does It Compare To Other Pneumococcal Vaccines
Like Prevnar 20, Prevnar 13 is a conjugate vaccine that works in a similar way to protect you against pneumococcal disease. Pneumovax 23, on the other hand, is a polyvalent vaccine that works by producing antibodies against pneumococcal bacteria.
No vaccine is 100% effective at preventing disease, but all three pneumococcal vaccines Prevnar 13, Prevnar 20, and Pneumovax 23 are considered safe and effective for helping protect against pneumococcal disease. And this latest FDA approval demonstrates ongoing pneumococcal vaccine development, with more candidates currently in the pipeline.
Lets review some key differences between the vaccines.
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What Is Pneumococcal Pneumonia
Simply put, itâs an infectious, potentially serious bacterial lung disease. The symptoms can hit without warning and can take you out of your routine for weeks. It could even put you in the hospital.
Did you know there is more than one type of pneumonia? Although pneumonia always means an infection of the lungs, there are actually many different types. Two of the most common types are viral and bacterial.
The most common type of bacterial pneumonia is called pneumococcal pneumonia.
Pneumococcal pneumonia can be serious. Symptoms can come on quickly, and can include cough, fatigue, high fever, shaking chills, and chest pain with difficulty breathing. Some symptoms can last weeks or longer.
In severe cases, pneumococcal pneumonia can lead to hospitalization. Or in some cases, even death.
Pneumococcal pneumonia is not a cold or the flu. It is a bacterial lung disease, while the flu and cold are caused by viruses.
In some cases, pneumococcal pneumonia can cause part of your lung to fill up with mucus, making it hard to breathe.
You can catch pneumococcal pneumonia through coughing or close contact. It can strike anywhere, anytimeâand may hit quickly and without warning.
Itâs not just old and unhealthy people who are at risk for pneumococcal pneumonia. If you are 65 or older, you may be at increased risk for pneumococcal pneumonia, even if you are otherwise healthy. Thatâs because as you get older, your immune system becomes less able to respond to infections.
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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Types Of Pneumococcal Infection
Pneumococcal infections usually fall into one of two categories:
- non-invasive pneumococcal infections these occur outside the major organs or the blood and tend to be less serious
- invasive pneumococcal infections these occur inside a major organ or the blood and tend to be more serious
Non-invasive pneumococcal infections
Non-invasive pneumococcal infections include:
- sinusitis infection of the sinuses
Invasive pneumococcal infections
- bacteraemia a relatively mild infection of the blood
- osteomyelitis infection of the bone
- pneumonia infection of the lungs
- meningitis infection of the meninges
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.
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Types Of Doctors Who Treat Pneumonia
In some cases, primary-care physicians, including pediatricians, internists, and family medicine specialists may treat pneumonia. In more severe cases, other types of specialists may be involved in caring for the patient with pneumonia. These include infectious-disease specialists, pulmonologists, critical-care specialists, and hospitalists.
How Are They Diagnosed
Most people with walking pneumonia dont go to the doctor because their symptoms are very mild. However, doctors use the same approach to diagnose both types of pneumonia.
To start, theyll likely listen to your lungs with a stethoscope to check for signs of a problem with your airways. They may also ask about your lifestyle, including the kind of environment you work in and whether you smoke.
In some cases, your doctor might use an X-ray look at your chest. This can help them differentiate between pneumonia and other conditions, such as bronchitis. Depending on your symptoms, they may also take a blood sample, swab your throat, or take a mucus culture to determine which type of bacteria is causing your symptoms.
THE MAIN DIFFERENCE:
The symptoms of walking pneumonia are often mild enough that people dont go to the doctor. If you do, however, your doctor will follow the same process for diagnosing either walking pneumonia or pneumonia.
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What Are The Treatments For Pneumonia
Treatment for pneumonia depends on the type of pneumonia, which germ is causing it, and how severe it is:
- Antibiotics treat bacterial pneumonia and some types of fungal pneumonia. They do not work for viral pneumonia.
- In some cases, your provider may prescribe antiviral medicines for viral pneumonia
- Antifungal medicines treat other types of fungal pneumonia
You may need to be treated in a hospital if your symptoms are severe or if you are at risk for complications. While there, you may get additional treatments. For example, if your blood oxygen level is low, you may receive oxygen therapy.
It may take time to recover from pneumonia. Some people feel better within a week. For other people, it can take a month or more.
How The Intervention Might Work
The clinical effectiveness of PPSV and PCV have been summarised in two Cochrane Reviews. examined the effectiveness of PCV in children younger than two years. The review included trials comparing PCV to placebo or to other vaccines. PCV was found to be effective in preventing VT IPD 0.20, 95% confidence interval 0.10 to 0.42)), Xraydefined pneumonia ) and clinical pneumonia ).
examined the effectiveness of PPSV for adults. The review included trials comparing PPSV to placebo, control vaccine or no intervention. The risk of all IPD was shown to be reduced by PPSV 0.26, 95% CI 0.14 to 0.45) PPSV also decreased the incidence of allcause pneumonia but with significant heterogeneity. Further analysis demonstrated that the efficacy against allcause pneumonia is significant only in lowincome countries. PPSV did not result in a significant reduction in allcause mortality in all settings. An ongoing review is assessing the efficacy and relative effectiveness of different pneumococcal vaccines among patients with HIV .
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Who Should Not Get Pneumovax 23 Or Prevnar 13
Children younger than 2 years of age should not get Pneumovax 23. In addition, while there is no evidence that Pneumovax 23 is harmful to pregnant women or their babies, as a precaution, women who need Pneumovax 23 should get it before becoming pregnant, if possible.
Before you get either Prevnar 13 or Pneumovax 23, tell your health provider if you have had any life-threatening allergic reaction to or have a severe allergy to pneumococcal vaccines or any vaccine containing diphtheria toxoid . Also, tell your health provider if you are not feeling well. If you have a minor illness like a cold, you can probably still get vaccinated, but if you have a more serious illness, you should probably wait until you recover.
Who Should Get The Vaccine
People over age 65. As you age, your immune system doesnât work as well as it once did. Youâre more likely to have trouble fighting off a pneumonia infection. All adults over age 65 should get the vaccine.
Those with weakened immune systems. Many diseases can cause your immune system to weaken, so itâs less able to fight off bugs like pneumonia.
If you have heart disease, diabetes, emphysema, asthma, or COPD , youâre more likely to have a weakened immune system, which makes you more likely to get pneumonia.
The same goes for people who receive chemotherapy, people who have had organ transplants, and people with HIV or AIDS.
People who smoke. If youâve smoked for a long time, you could have damage to the small hairs that line the insides of your lungs and help filter out germs. When theyâre damaged, they arenât as good at stopping those bad germs.
Heavy drinkers. If you drink too much alcohol, you may have a weakened immune system. Your white blood cells donât work as well as they do for people with a healthy immune system.
People getting over surgery or a severe illness. If you were in the hospital ICU and needed help breathing with a ventilator, youâre at risk of getting pneumonia. The same is true if youâve just had major surgery or if youâre healing from a serious injury. When your immune system is weak because of illness or injury or because itâs helping you get better from surgery, you canât fight off germs as well as you normally can.
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