When Do I Need Pneumonia Vaccines?

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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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.

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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