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Pneumococcal Vaccination for Adults

RMpneumonia

The pneumococcal vaccine prevents serious blood, brain, and lung infections from the Streptococcus pneumoniae bacteria. Such infections are called pneumococcal disease — they also include pneumonia, meningitis, and septicemia.

Pneumococcal disease is a serious health threat that can lead to death. Many strains of Streptococcus pneumonia are resistant to antibiotics. Infection with the bacteria is a leading cause of serious illness in adults and children worldwide. In the U.S. alone, more people die from pneumococcal disease each year than all other vaccine-preventable diseases combined.

Vaccination is the best way to prevent pneumococcal disease. There are two different types of pneumococcal vaccine. One that protects adults against 23 strains of Streptococcus pneumonia bacteria is called pneumococcal polysaccharide vaccine (PPSV23), and it is marketed under the brand name Pneumovax. PPSV23 is made using dead bacteria. The dead germs cannot make you sick.

The other is pneumococcal conjugate vaccine, PCV13 (brand name Prevnar 13), which is routinely given to infants and toddlers, but was approved by the FDA in 2011 for use in adults 50 and older.

When Should Adults Get a Pneumococcal Vaccine?

The pneumococcal vaccine can be given at any time of the year. The pneumococcal polysaccharide vaccine (PPSV23) is recommended for the following adults:

• Adults 19 to 64 years old with certain medical conditions (for example, certain kidney diseases, cigarette smoking, asthma, chronic heart or lung disease, asplenia, and conditions that cause weakening of the immune system) should receive one or two doses of PPSV23 given five years apart.

The pneumococcal conjugate vaccine (PCV13) is recommended for the following adults:

• Adults 19 and older with asplenia, sickle cell disease, cerebrospinal fluid leaks, cochlear implants, or conditions that cause weakening of the immune system.

It’s now recommended that adults age 65 and older get both vaccines. Adults who are recommended to get both the PPSV23 and the PCV13 vaccines should get the PCV13 vaccine first, followed by PPSV23 8 weeks later. If an adult was already vaccinated with PPSV23, he or she should receive the PCV13 vaccine 1 year or more later.

Who Needs a Booster Shot of the Pneumococcal Vaccine?

Some people may need a booster shot after 5 years. The doctor will recommend a second dose of PPSV23 if you are an adult between ages 19 and 64 who has:

•A damaged spleen or no spleen
• Kidney disease called nephritic syndrome
•A weakened immune system due to medications such as chemotherapy drugs and long-term steroids
• Cancer, including leukemia, lymphoma, and multiple myeloma
•History of an organ or bone marrow transplant
• HIV/AIDS
•Sickle cell disease

Adults over age 65 who received PPSV23 before age 65 also need a booster shot if it has been more than 5 years since being vaccinated.

Who Should NOT Get the Pneumococcal Vaccine?

You should NOT get the PPSV23 or the PCV13 vaccine if you have had:

•A life-threatening allergic reaction to either vaccine
•A severe allergy to any of the vaccines’ ingredients

If you are moderately to severely ill, your doctor may recommend waiting to get the shot until after you recover. The CDC says you can still get the vaccines if you have a mild illness, such as a cold or low-grade fever.

It is not known whether the PPSV23 and PCV13 vaccines are safe to get during pregnancy. But there have been no reports of harm to babies whose mothers received the vaccine before realizing they were pregnant. Pregnant women should only receive these vaccinations if they are clearly needed.

What Are the Side Effects and Risks of the Pneumococcal Vaccine?

Like all vaccines, both PPSV23 and PCV13 can have side effects. But the risk of harm or death from either is extremely rare.

Reported side effects are similar for both vaccines. Some people may have mild swelling, redness, and soreness where the shot was given. This goes away in a few days.

Less than 1% of people who receive these vaccines may have:

•Fever
•More severe swelling, pain, or redness where the shot was given
•Muscle aches

Rarely, someone may have a severe allergic reaction to an ingredient in the vaccines. Most of the time, such reactions occur within a few minutes of receiving a pneumococcal vaccine. The following can be signs of a severe allergic reaction:

•Behavior changes
•Breathing difficulty, including wheezing
• Dizziness
•Hoarse voice
• High fever
• Hives
•Pale skin
•Rapid heart beat
• Weakness

Seek immediate medical care if you notice any of these signs after receiving either pneumococcal vaccine.

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