Dr. McCurley on the Pneumonia Vaccine
November 16, 2007 • John McCurley, MD
Pneumonia is a serious infection involving the lung which can be fatal if not treated appropriately. This is especially true in older patients, those with weakened immune systems, and those with underlying medical conditions. It can be caused by many different things – including viruses and bacteria. Each year in the United States there are about four million documented cases of pneumonia. The most common “bug†that causes severe infections is a bacterial agent known as pneumococcus. More people die from pneumococcal infections than from any other vaccine preventable disease. It is estimated that 40,000 people die every year in the United States from infections with this bacteria.
Pneumonia is transmitted from person to person, with airborne particles released by sneezing and coughing adding to the risk of passing the bacteria. Factors that increase the likelihood of developing pneumonia include cigarette smoking (as well as passive exposure to “second hand smokeâ€), alcohol abuse, asthma, and anything that results in your immune system being compromised – cancer, HIV, Lupus, transplant recipients, patients undergoing chemotherapy, and multiple myeloma.
Typical symptoms of community acquired pneumonia include fever, chills, productive cough with pain in the side, and nighttime sweats. As we age we are at increased risk for infection with pneumonia and tend to exhibit fewer of these symptoms.
The first attempt at a vaccine for pneumonia was used over 60 years ago. The current adult vaccine was developed in 1983 and protects against 23 different strains of the pneumococcal bacteria. This vaccine decreases the risk of developing a severe (invasive) infection by about 2/3. It is important to note that it does not decrease the risk of any other type of pneumonia – for instance, viral pneumonia. And it does not decrease the risk of non-invasive or mild pneumonia.
So, should you get the pneumonia vaccine? The Centers for Disease Control recommends this vaccine for all adults age 65 or older as a one time vaccine. It is also recommended for adults (age 19-64) with chronic heart or lung disease as well as those with diabetes mellitus, alcoholism or chronic liver disease. Patients who no longer have their spleen or those with sickle cell disease should be vaccinated. Patients with cerebrospinal fluid leaks or cochlear implants should also receive this vaccine. Finally, those under age 65 living in chronic care facilities should receive this vaccination. In certain rare cases revaccination with a second dose is also recommended.
You should also know that it is okay to receive this one time vaccine at the same visit that you are given your annual flu shot. So if you are 65 years of age or older, or have one of the conditions discussed above, you should discuss getting this vaccine with your physician this year.