By Jina Sung, Pharm.D. Candidate, Class of 2020, The Ohio State University
There are 1.7 million people in the United States visiting emergency departments with pneumonia as the primary diagnosis, according to an annual National Hospital Ambulatory Medical Care Survey, and about 50,000 people die every year due to pneumonia. This is why it’s essential for vulnerable populations to protect themselves from this disease, especially older adults.
Updates to Pneumonia Vaccine Recommendations for Adults over 65
There are two types of vaccines against pneumococcal disease: pneumococcal conjugate vaccine (PCV 13) and pneumococcal polysaccharide vaccine (PPSV23). PCV 13 is available under the brand name Prevnar 13 and PPSV23 is sold as the brand Pneumovax 23. For all adults aged 65 years or older, CDC used to recommend a routine series of Prevnar 13 and Pneumovax 23 vaccines. However, due to the decline of pneumococcal disease among seniors as a result of vaccinations, guidelines have changed.
In June 2019, the Advisory Committee on Immunization Practices (ACIP) decided that for healthy adults aged 65 or older, the vaccine may not be necessary. ACIP now recommends that patients have a conversation with their doctor to decide whether to get Prevnar 13. However, older adults who have a high risk for pneumococcal disease should still receive both Prevnar 13 and Pneumovax 23. Additionally, Pneumovax 23 is still recommended for all adults over age 65.
|Old Recommendation for Older Adults||New Recommendation for Older Adults|
|For all adults 65 years old or older*:|
Administer 1 dose of PCV 13 first, and give 1 dose of PPSV23 at least 1 year later
|For adults 65 years old or older who do not have immunocompromising condition*:|
Administer 1 dose of PPSV23
For adults 65 years old or older with an immunocompromising condition, cochlear implant, or cerebrospinal fluid leak*:
Administer PCV13 first, and give PPSV23 at least 8 weeks
* For more information, visit CDC website at https://www.cdc.gov/vaccines/vpd/pneumo/downloads/pneumo-vaccine-timing.pdf
Should Adults Over 65 Get Prevnar 13?
PCV13 (Prevnar 13) 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.
What is Pneumonia?
Pneumonia is an infection mostly caused by streptococcus pneumoniae bacteria that inflames the air sacs in one or both lungs. People with the infection may experience cough with phlegm, fever, and difficulty breathing. The severity of pneumonia can range from mild to life-threatening. People with health problems, such as asthma or COPD, or weakened immune systems have a higher risk of getting more severe pneumonia.
Who Should Get Pneumonia Vaccines?
The Center for Disease Control and Prevention (CDC) recommends routine pneumococcal vaccinations for children younger than 2 years old or adults 19 and older. There are additional pneumonia vaccine guidelines for people with certain medical conditions or weakened immune systems.
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