Who Should Get the Pneumonia Vaccine?

By Michael Lasalandra

BIDMC Correspondent


There are many different types of bacteria that can cause community acquired pneumonia, or CAP. But, the good news is that there are effective vaccines to prevent the illness.


The Centers for Disease Control recommends vaccination against a form of pneumonia triggered by a form of streptococcus bacteria known as Streptococcus pneumoniae or pneumococcus.  Most at risk include young children, the elderly, and those with certain medical conditions.


“We can get really sick, really fast, from this bacteria,” says Dr. Michael Wong, infectious disease specialist at Beth Israel Deaconess Medical Center. “It can cause not only pneumonia but infections of the blood, infection around the brain, meningitis, and even death.”


Fortunately, there are two vaccines that protect against it.


Vaccines for Those Most at Risk


Pneumococcal conjugate vaccine (PCV13) is recommended for all children under 5 years of age and for adults over age 19 with certain risk factors. It is also used to “prime” the immune system prior to receiving the other type of vaccine, pneumococcal polysaccharide vaccine (PPSV23), which is recommended for all adults 65 years or older and for those over age 2 with certain risk factors.


The two protect only against the form of pneumonia known as pneumococcal pneumonia.


The risk factors are many, but include having or being at high risk for diseases such as sickle cell disease, HIV or other conditions that compromise the immune system, chronic lung disease, and chronic obstructive pulmonary disease (COPD).


The vaccine is also recommended for those ages 19 through 64 who smoke cigarettes or who have asthma.


Individuals with certain risk factors may consider being immunized with both vaccines.


“If there is something we can do to prevent the complications of pneumonia, it makes sense to do it,” says Dr. Wong.


“This vaccine is easy to get and can protect against a potentially deadly illness,” he says.


“Repeat vaccination every few years is required to keep the protective response high, but the strategies for vaccination continue to change,” he says. “We are learning so much about how best to protect our patients.”


Side effects are generally mild, he says, and may include pain at the injection site, headache, fatigue or a general feeling of discomfort.


The vaccine does not protect against viral pneumonia, nor does it protect against bacterial strains not included in the vaccine. These include the type usually present in health care settings.


Promising Results


According to the CDC, more than 1 million people in the United States were hospitalized for pneumonia in 2014, and more than 50,000 died from it.


The pneumonia vaccine, then known as PCV7, was introduced in 2001 and rates of pneumonia have dropped 32 percent in young people and 18 percent in the elderly. Still, only about one third of adults get vaccinated. The newer version, PVC13, introduced in 2010, protects against more subtypes of the pneumococcal bacterium. Giving this first followed by the PPSV23 vaccine helps get a more robust immune response to 23 different subtypes.


In addition, a new study shows that giving the pneumococcal conjugate vaccine to infants — it was originally developed to prevent blood and ear infections — also seems to protect the elderly, reducing pneumonia hospitalizations by 10 percent. It stems from having fewer children being able to transmit the bacteria to the elderly,



Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.