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Pneumoccal Vaccine Revisited

Pneumonia Vaccination

(more clarification is needed)

OK—So I’ve talked about adult immunizations before and though it is admittedly confusing, I hope I’ve convinced someone of the necessity of these preventive measures.

Pneumonia continues to be a major cause of death. It is also a frequent finding in other disease processes.

To prevent pneumococcal pneumonia (the most common bacterial pneumonia) there are two choices of vaccination. The conventional vaccination is Pneumovax 23. Pneumovax 23 has been used to prevent pneumococcal pneumonia for years. Now there is a more specific vaccine available. The new vaccine is called Prevnar 13. It provides additional protection and when used in conjunction with the older vaccine, it is the most current and recommended treatment.

Did you ask, “How do you use both vaccines?”

Here’s how. First let’s talk about healthy folks that are 65 or older. If they have had no vaccinations, Prevnar 13 is recommended. After the initial Prevnar 13 vaccination, the Pneumovax 23 can complete the protection a year later. The jury is still out on whether future immunizations are needed. My guess is that years later, after pneumonia protection is monitored by the CDC, some recommendation for future vaccination will be upcoming.

What about the folks who have previously received the traditional pneumonia vaccination? The Prevnar 13 should be given no sooner than one year after the initial Pneumovax. If the initial Pneumovax was given before the age of 65, a second dose of the traditional Pneumovax should be given five years after the initial and at least one year after the Prevnar 13. Are we confused enough yet?

Now, what about the younger patients (between 19 and 65) who have impaired immunity and are at higher risk of infections. They get the Prevnar 13 initially and eight weeks or more later are followed up with the Pneumovax. Additional doses of the Pneumovax may be needed later.

This can easily get complicated and new recommendation come all the time as we learn more about these bacteria and as they evolve in the community. So please fall back on the time honored advice—Ask your doctor.

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