Pneumonia Vaccines – What’s New for Adults in 2020
Betty Chaffee, PharmD, is owner and sole proprietor of BetterMyMeds, a Medication Management service devoted to helping people get the maximum benefit from their medications.
Vaccination against pneumonia is an important way to protect yourself from one of the most common life-threatening infections. Pneumonia affects people of every age, but is more serious for those at both ends of the age spectrum. It’s estimated that one million people will be hospitalized in the United States this year for pneumonia. Worse, it's likely that 50,000 of the infections will end in death. Causes of pneumonia include viruses and bacteria, but one of the more common causes is streptococcus pneumoniae, or pneumococcus. Pneumonia vaccines are effective at helping the body fight pneumococcus and the infections it can cause, including pneumonia.
Pneumonia vaccines for adults
There are currently two pneumonia vaccines approved for use in adults. Pneumovax-23 has been in use for about 35 years. It contains inactivated particles of the 23 most common strains of pneumococcus that cause disease in adults.
Prevnar-13 has been around since 2010 but was originally approved for use only in children. It wasn't used routinely for adults until about 5 years ago. Prevnar-13 contains inactivated particles of 13 strains of pneumococcus that tend to cause disease in children. It was hoped that vaccinating children would not only protect them from disease, but would decrease transmission of bacteria to adults, too.
Both vaccines are quite safe; the most common adverse effect is discomfort at the injection site for a day or two.
Current recommendations for pneumonia vaccination in adults
In 2014, the Food and Drug Administration approved Prevnar-13 for use in adults as well as children. It turns out programs to vaccinate children weren't widely accepted yet, so pneumonia was still a major health threat to both kids and adults. Experts decided that vaccination of older adults was the best way to decrease the impact of this disease for all. Child vaccination programs continued when adult programs began.
So in 2014, it was recommended that all adults be vaccinated with Prevnar-13 at age 65 (or as soon as possible thereafter), then a year later receive Pneumovax-23. Those younger than 65 with certain chronic health conditions such as heart or lung disease, diabetes, and others were to receive Pneumovax-23 once between the ages of 18 and 64. A second dose of Pneumovax-23 was given to these folks a year after they received Prevnar-13 (or 5 years after the first Pneumovax-23, whichever was later).
But partway through 2019, immunization experts agreed that the pneumonia vaccination programs for children were finally beginning to work. Less pneumococcal disease was being caused by the strains contained in Prevnar-13. Vaccinating the children had effectively decreased the transmission of infections, and older adults were at far less risk. Experts considered taking Prevnar-13 out of adult vaccine recommendations altogether.
Unfortunately, there are still areas in the United States where immunization programs haven’t taken off as well. In those areas, older adults are still at risk of infection with these 13 strains of bacteria. So instead of leaving Prevnar-13 completely out of the recommendations for adults, experts suggest that all adults 65 years of age and older talk with their doctor. Risks and benefits of vaccination should be discussed, along with individual values and concerns. Together, patients and their doctors should make a decision about whether Prevnar-13 is indicated. Those who have chronic health problems that weaken their immune systems are still candidates for Prevnar-13 regardless of where they live.
Recommendations for Pneumovax-23 have not changed. Pneumovax-23 is still to be administered between the ages of 18 and 64 to any adult with certain chronic health problems. Health problems that severely affect the immune system may require two doses of Pneumovax-23 for those between 18-64. A final dose is given again at age 65 (or at least one year after Prevnar-13 or 5 years after the previous Pneumovax-23).
Talk to your doctor or pharmacist to make sure you’ve been adequately vaccinated against pneumonia!
The recommendations above may seem complicated, but your doctor or pharmacist can help. If you already have an appointment scheduled with your doctor, be sure to ask whether you're up-to-date on your pneumonia vaccine. But you don't have to wait for an appointment with your doctor to get your vaccination. Your pharmacist likely has the vaccination you need in stock and can provide it to you without an appointment. Your pharmacist can even check your immunization records if you're not sure what you need.
Answers to frequently asked questions about preventing pneumonia can be found here. We welcome your comments and questions, which can be posted below. And as always, you can contact us at BetterMyMeds for more information!