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
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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.
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.
Do I Need To Pay For Pneumococcal Immunisation
Vaccines covered by the National Immunisation Program are free for people who are eligible. See the NIP Schedule to find out which vaccines you or your family are eligible to receive.
Eligible people get the vaccine for free, but your health care provider may charge a consultation fee for the visit. You can check this when you make your appointment.
If you are not eligible for free vaccine, you may need to pay for it. The cost depends on the type of vaccine, the formula and where you buy it from. Your immunisation provider can give you more information.
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Why Do You Need Booster Shots
The tetanus vaccine doesnt provide lifelong immunity. Protection begins to decrease after about 10 years, which is why doctors advise booster shots every decade.
A doctor may recommend children and adults get a booster shot earlier if theres a suspicion they may have been exposed to tetanus-causing spores.
For example, if you step on a rusty nail or have a deep cut thats been exposed to infected soil, your doctor may recommend a booster.
Some people shouldnt be vaccinated, including people who:
- had severe reactions to previous doses of the vaccine
- have Guillain-Barré syndrome, a neurological immune disorder
Pneumococcal Infections After Influenza
Pneumococcus is known as an opportunistic infection because it lives in the respiratory tract of people without causing disease, but when the respiratory tract is compromised by an infection such as influenza, the bacteria then invades the lungs , bloodstream , or brain and spinal cord . Activities like smoking can also disrupt the lining of the nose and throat and allow for pneumococcal infections and subsequent disease.
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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.
Which Adults Should Get The Pneumococcal Vaccine
The following groups of adults should get both types of the pneumococcal vaccine :
- Adults 65 years and older because they are at high risk of pneumococcal infections
- Adults without a functioning spleen
- Adults who are immune compromised by disease, chemotherapy or steroids
- Individuals who are HIV positive
The following groups of adults should get the polysaccharide pneumococcal vaccine regardless of age:
- Adults who smoke or suffer from alcoholism
- Adults with heart or lung disease, liver disease, asthma, diabetes or cancer
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What Are The Most Common Side Effects Of Pneumovax 23 And Prevnar 13
Side effects with pneumococcal vaccines are usually mild and go away on their own within a few days.
Common side effects of Prevnar 13 include:
Injection site pain
Common side effects of Pneumovax 23 include:
Injection site pain
Be sure to talk with your doctor if you experience any of these symptoms for a prolonged period of time.
Babies And The Pneumococcal Vaccine
Babies are routinely vaccinated with a type of pneumococcal vaccine known as the pneumococcal conjugate vaccine as part of their childhood vaccination programme.
Babies born on or after 1 January 2020 have 2 injections, which are usually given at:
- 12 weeks old
- 1 year old
Babies born before this date will continue to be offered 3 doses, at 8 and 16 weeks and a booster at 1 year.
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Flu Vaccines For Older Adults
Flu short for influenza is a virus that can cause fever, chills, sore throat, stuffy nose, headache, and muscle aches. Flu is very serious when it gets in your lungs. Older adults are at a higher risk for developing serious complications from the flu, such as pneumonia.
The flu is easy to pass from person to person. The virus also changes over time, which means you can get it again. To ensure flu vaccines remain effective, the vaccine is updated every year.
Everyone age 6 months and older should get an annual flu vaccine, but the protection from a flu vaccine can lessen with time, especially in older adults. Still, you are less likely to become seriously ill or hospitalized because of the flu if you get the vaccine. A flu vaccine is especially important if you have a chronic health condition such as heart disease or diabetes.
You should get your vaccine ideally by the end of October each year so you are protected when the flu season starts. It takes at least two weeks for the vaccine to be effective. However, if you have not received your flu vaccine by the end of October, its not too late as flu season typically peaks in December or January. As long as the flu virus is spreading, getting vaccinated will help protect you.
What Are The Side Effects Of The Pneumonia Vaccines
PCV13 and PPSV23 can both cause mild side effects. Both pneumococcal vaccines are given in the arm and are injected into muscle. Children and adults may experience arm soreness, swelling, or redness where the shot was injected. Other side effects that may occur in adults include:
PCV13 should not be given to children at the same time as the annual flu shot, because of an increased risk of . These seizures are caused by a high fever and occur in up to 5% of children under 5. They can be scary, but dont cause any long-term health problems.
The good news is that the side effects will resolve on their own within a few days.
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People With Health Problems And The Pneumococcal Vaccine
The PPV vaccine is available on the NHS for children and adults aged from 2 to 64 years old who are at a higher risk of developing a pneumococcal infection than the general population.
This is generally the same people who are eligible for annual flu vaccination.
Youre considered to be at a higher risk of a pneumococcal infection if you have:
- a suppressed immune system caused by a health condition, such as HIV
- a suppressed immune system caused by medicines, such as chemotherapy or steroid tablets
- a cochlear implant Action on Hearing Loss has more information about cochlear implants
- had a leak of cerebrospinal fluid this could be the result of an accident or surgery
Adults and children who are severely immunocompromised usually have a single dose of PCV followed by PPV.
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.
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How Do The Pneumonia Vaccines Work
Like all vaccines, pneumococcal vaccines work by showing the immune system a version of the microbe, or a part of it, that is responsible for the infection. The pneumococcal vaccine contains part of the pneumococcus bacterias outer shell, made of molecules called polysaccharides. The immune system learns to recognize it, attack it, and defend the body against it, should it ever come into contact with the real bacteria.
The body does this by making antibodies against the shell of the pneumococcus bacteria. These antibodies stay in your bloodstream as part of your immune system. If you are exposed to pneumococci in the future, the antibodies recognize the bacterias shell and launch a targeted defense.
There are strains of pneumococcus, so the vaccines are made up of molecules from many of those strains.
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How Do You Catch Pneumococcus
Pneumococcus is a bacterium that is commonly found lining the surface of the nose and the back of the throat in fact, about 25 of every 100 people are colonized with pneumococcus. Many children will come in contact with pneumococcus sometime in the first two years of life. Because most adults have immunity to pneumococcus, a mother will passively transfer antibodies from her own blood to the blood of her baby before the baby is born. The antibodies that the baby gets before birth usually last for a few months. However, as these maternal antibody levels diminish, the baby becomes vulnerable. Most children who first come in contact with pneumococcus don’t have a problem. But every year tens of thousands of children suffer severe, often debilitating, and occasionally fatal infections with pneumococcus most of these children were previously healthy and well nourished.
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An Ounce Of Prevention Is Worth A Pound Of Cure
In the 1940s all of the strains of pneumococcus could be treated with the antibiotic, penicillin. However, over time many pneumococcal strains have become resistant not only to penicillin, but also to other antibiotics developed to combat bacterial infections. Resistance means that bacteria have changed, or evolved, so that they are no longer killed by one or more antibiotics. As a result, treatment with those antibiotics is not effective against those resistant strains.
Strains of pneumococcus have now been identified that are highly resistant to most antibiotics. Our reliance on and overuse of antibiotics have led to this resistance, backing us into a corner when treating infections caused by these and other types of bacteria. Unfortunately, we have taken our first steps into a post-antibiotic era. This makes the use of vaccines all the more important.
Will Being Vaccinated Against Flu Pneumonia And Shingles Help Prevent Covid
The short answer is no. But reducing your risk for getting sick with the flu, pneumonia, or shingles which is what these vaccines do makes a lot of sense during the pandemic, Privor-Dumm says.
Lowering your risk for vaccine-preventable diseases will help you avoid doctors offices and hospitals, which will reduce any potential exposure to the coronavirus, Privor-Dumm adds.
Plus, Privor-Dumm says, Preventing serious disease can help keep you out of the hospital at a time when health resources may be needed to treat COVID-19 patients.
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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.
How Much Does It Cost
For adults over age 65 who have Medicare Part B, both pneumococcal vaccines are completely covered at no cost, as long as they are given a year apart.
If you have private insurance or Medicaid, you should check with your individual plan to find out if the vaccines are covered. Usually, routinely recommended vaccinations, like the pneumococcal vaccines, are covered by insurance companies without any copays or coinsurance. This means you can often get the vaccines at little or no cost.
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Who Should Get Prevnar 13 And Pneumovax 23
Prevnar 13 was developed for infants and children. The CDC recommends that all infants and children younger than 2 years of age get Prevnar 13. Prevnar 13 involves a series of four doses of the vaccine given at 2 months, 4 months, 6 months, and sometime between 12 and 15 months of age.
Pneumovax 23 is the vaccine used in adults. It does not work in infants and children under 2 years old.
Most adults do not need a pneumococcal vaccine until they reach the age of 65. Once a person turns 65 years old, the CDC recommends Pneumovax 23.
The same is true for any adult who smokes or has one or more of these chronic illnesses:
Chronic heart disease
Chronic lung disease, including asthma and chronic obstructive pulmonary disease
Chronic liver disease
How Much Do Pneumovax 23 And Prevnar 13 Cost
Pneumovax 23 and Prevnar 13 can be quite expensive without insurance. One dose of Pneumovax 23 currently costs around $135 cash price, while one dose of Prevnar 13 costs around $250 cash price. With a GoodRx coupon, you might be able to reduce your cost for these to around $90 and $195, respectively. Read here for information on how to use a GoodRx coupon for vaccines.
All health insurance marketplace plans under the Affordable Care Act, and most other private insurance plans, must cover pneumococcal vaccines without charging a copayment or coinsurance when an in-network provider administers the vaccine even if you have not met a yearly deductible. Medicare does not cover either vaccine.
Remember: The recommendations for who should get a pneumonia vaccination are based on risk factors and age, so be sure to talk to your doctor if you think you might need one. You should be able to receive both Pneumovax 23 and Prevnar 13 at your local pharmacy. Depending on which state you live in, these vaccines may not require a prescription. Be sure to reach out to your pharmacist for more information. The CDC has more information about these vaccinations here.
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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.
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.
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.