"People age 65 and older should get two separate vaccines to protect against pneumonia and other infections, a change of decades-old advice, according to new health guidelines.
An advisory panel to the U.S. Centers for Disease Control and Prevention recently recommended that people get a second vaccine, called Prevnar 13, because of limitations with the older shot, called Pneumovax 23." (WSJ, Sept 1, 2014)
Pneumococcal infections including pneumonia and meningitis are common and up until recently the only vaccine recommended for adults was the PPSV23.
There is no revaccination necessary with Prevnar13.
- For adults 19 to 64 years of age at intermediate risk of pneumococcal disease (i.e., cigarette smokers; patients with chronic heart disease, chronic lung disease, diabetes mellitus, alcoholism, or chronic liver disease) the recommendation is to receive PPSV23 alone. Prevnar 13 is not indicated.
- For adults aged 19 or older who are at high risk of pneumococcal disease (i.e., patients with functional or anatomic asplenia, an immunocompromising condition [e.g., HIV infection, cancer], a cerebrospinal fluid leak, a cochlear implant, advanced kidney disease), Prevnar 13 followed at least eight weeks later by PPSV23 is the recommendation.
- In patients who have already received PPSV23, at least one year should elapse before they are given Prevnar 13.
- A single revaccination with PPSV23 is recommended in adults ≥65 years of age if they were vaccinated more than five years previously at a time when they were less than 65 years of age and, in immunocompromised patients, five years or more after the first dose.