"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)
We ask SIMED Pulmonology physician Jorge Camacho, MD to touch base on the new indications for pneumonia vaccine (Prevnar 13) and what that might mean to you or your loved ones.
Pneumococcal infections including pneumonia and meningitis are common and up until recently the only vaccine recommended for adults was the PPSV23.
Starting in 2014 the United States Advisory Committee on Immunization practices recommended a new pneumococcal vaccine known as PCV13 with the commercial name of Prevnar 13.
This type of vaccine has been shown to be very effective in preventing invasive pneumococcal infections in children causing a dramatic decrease in that type of infections. Randomized trials were done in adults finding the vaccine to be highly effective as well, because of that the recommendations changed.
The current recommendation is to vaccinate every adult above the age of 65 with the 2 available vaccines. The Prevnar 13 vaccine should be given first followed by the PPSV23 6 to 12 months later. In those who have already received PPSV23, at least one year should elapse before they are given Prevnar 13.
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.
Prevnar 13 is not
recommended for healthy adults below 65 years of age who do not have a specific risk factor for pneumococcal infection."
For more information on whether you should get the immunization, please contact your SIMED provider.