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When Do I Need Pneumonia Vaccines?

by Dr. Sharon Orrange on July 19, 2016 at 1:37 pm

Strep pneumonia also known as pneumococcal pneumonia is a major cause of bacterial pneumonia in adults. There are 90 different strains (serotypes) of strep pneumonia, and even if you’ve had one type, you are only immune to that one type again.

Because your immune response is specific to that type, you still need a vaccine to help you out. Two in fact. Two vaccines that cover 23 different serotypes (aka strains) of pneumococcal pneumonia.

There are two vaccines for pneumonia:
Pneumovax 23 was introduced in 1983 and covers 23 strains of pneumonia.

Prevnar 13 which is not new, but it is a new recommendation for adults. This vaccine gets a better immune response though it only covers 13 types.

I’m 65 or older—should I get the pneumonia vaccines?

Yes. If you have not been vaccinated you will get your Prevnar first, followed one year later by your Pneumovax. The two pneumonia vaccines have to be separated by one year. You are then done with pneumonia vaccines, and do not need any sort of booster.

Why do I need both?

Though the Prevnar vaccination, the new recommendation, covers the same strains as the Pneumovax, the immune response seen when you receive both is better.

Why can’t Prevnar 13 and Pneumovax 23 be given together?

Unlike flu shots with pneumonia vaccines, the two pneumonia vaccines cannot be given together. Not because it’s dangerous—but because there is “immunologic interference” making them less effective. The sequence and timing is important. Closer spacing of these vaccines does not induce as good a response. Remember this is only a problem with the two pneumonia vaccines, and not the flu shot.

Do I need both of the pneumonia vaccines if I’m younger than 65?

Yes—if you belong to the following groups listed below. You’ll still get your Prevnar first and your Pneumovax one year later.

  • Cigarette smokers aged 19 and older. This group is often forgotten. People who smoke are at higher risk of pneumococcal pneumonia—get vaccinated.
  • Diabetes mellitus. This is another group that is often forgotten. Every person with diabetes needs their two pneumonia vaccines.
  • Chronic heart disease: congestive heart failure, cardiomyopathies. This does NOT include folks with high blood pressure.
  • Chronic lung disease like asthma, COPD and emphysema.
  • Alcoholics.
  • Chronic liver disease, cirrhosis.
  • Immunocompromised folks. This includes: HIV infection, leukemia, congenital immunodeficiency, Hodgkin’s disease, lymphoma, multiple myeloma, generalized malignancy or on immunosuppressive therapy.
  • Solid organ transplant patients.
  • Chronic kidney failure.
  • The rest. Candidates for cochlear implants, patients who’ve had their spleen removed, people with cerebrospinal leaks (CSF) leaks.

What If I have already received both vaccines before the age of 65?

Then you will get your booster (second doses) at 65 and 66, with one exception. You can not receive a two doses of Prevnar within 5 years of each other.

Dr O.

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