Pneumonia Shot Widely Recommended, Little Used

A person receiving a shot in the arm.

hide captionPneumonia vaccines are usually available at the same places that flu vaccines are: grocery store clinics, doctor's offices and walk-in clinics.

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Who Should Get the Vaccine?

  

Here, the Centers for Disease Control and Prevention's current recommendations on who should get the pneumonia shot:

  

All adults 65 years of age or older.

  

Anyone over 2 years of age who has a long-term health problem such as:

- heart disease

- lung disease

- sickle cell disease

- diabetes

- alcoholism

- cirrhosis

- leaks of cerebrospinal fluid

  

Anyone over 2 years of age who has a disease or condition that lowers the body's resistance to infection, such as:

- Hodgkin's disease

- lymphoma, leukemia

- kidney failure

- multiple myeloma

- nephrotic syndrome

- HIV infection or AIDS

- damaged spleen, or no spleen

- organ transplant

  

Anyone over 2 years of age who is taking any drug or treatment that lowers the body's resistance to infection, such as:

- long-term steroids

- certain cancer drugs

- radiation therapy

  

Alaskan Natives and certain Native American populations.

Flu vaccination rates have grown as people realize the protection the shot brings. But only 57 percent of people age 65 and older who are advised to get a pneumonia vaccine have ever gotten one.

People who have chronic conditions, such as diabetes and heart, lung or kidney disease, are also advised to get vaccinated. Yet, many of these individuals have not been vaccinated either.

The adult pneumonia shot, Pneumovax, protects against 23 strains of pneumococcal bacteria. This bacterium commonly causes pneumonia, which is an inflammation or infection of the lungs. The bacteria can also cause bacteremia (blood infection), meningitis (infection of the covering of the brain and spinal cord) and other infections.

The vaccine does not prevent all cases of pneumonia, but it's very effective in protecting people from these more aggressive pneumococcal diseases.

"That's where the vaccine has proved its mettle," says Dr. Pierce Gardner, an infectious disease expert. "And it's a very safe vaccine."

There are approximately 175,000 hospitalizations each year due to pneumococcal disease, and thousands of deaths. Half of the people who die from pneumococcal disease are 65 and older.

The risk starts to climb significantly at about age 50, so Gardner favors lowering the recommended age from 65 to 50.

Issues with Vaccine Remain

"The CDC's Advisory Committee on Immunization Practices may consider changing its recommendations," says the CDC's Pekka Nuorti.

There are a couple of issues holding the committee back. Experts don't know exactly how long the vaccine lasts. People who get the pneumonia vaccination are frequently advised to get a second dose five or 10 years later, but there's concern that the subsequent doses may not provide as much immunity.

"There's a little bit a sense that you don't have an infinite number of bullets in the gun here," Gardner says. "And so you need to shoot it at the right time."

Vaccinating in Childhood

The concerns about re-vaccination or "boosting" the pneumonia vaccine may become moot once a newer vaccine is introduced. Manufacturers are working on a conjugate vaccine that's similar to Prevnar, the pneumococcal vaccine that is now given to children.

Since Prevnar was introduced in 2000, studies suggest it has led to a 90 percent reduction in the incidence of serious pneumococcal infections in targeted children. There's also evidence of herd immunity, says Dr. Orin Levine of Johns Hopkins' School of Public Health.

"When we vaccinated young children in the U.S. with pneumococcal vaccines, we did a great thing for children," Levine says. "But we also did a great thing for their parents and grandparents." Levine says kids are no longer spreading the infection to their family.

The childhood vaccine seems to hold up well in kids, but it doesn't protect against all strains of the pneumococcal bacteria that turn up in adult diseases.

For this reason, experts say older folks need their own shot — if not by age 50, then certainly by 65.

The shot is offered most places the flu shot is offered, including grocery store clinics, doctor's offices and walk-in clinics such as MinuteClinics. The cost is approximately $40.

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