CDC recommends 2 pneumonia vaccines for older adults

The Advisory Committee on Immunization Practices is recommending that all older adults aged 65 or more years obtain two vaccines against pneumonia: PCV13 (Prevnar-13, Wyeth/Pfizer), otherwise known as the conjugate vaccine, and PPSV23 (Pneumovax23, Merck), the polysaccharide vaccine. Each vaccine is needed only once in a lifetime for most adults.

The polysaccharide vaccine has been used in adults to protect against pneumonia for several years, and the conjugate vaccine “has been tremendously effective in kids, and we’ve seen the number of pneumococcal cases plummet in recent years,” Centers for Disease Control and Prevention (CDC) Director Tom Frieden, MD, MPH, noted at a Sept. 18 press conference.

“This new combination of pneumococcal vaccines is expected to reduce vaccine-type pneumonia in people aged 65 and older by about 45 percent and reduce invasive disease, the most deadly form, by 75 percent,” said William Schaffner, MD, professor of preventive medicine and infectious diseases at the Vanderbilt University School of Medicine and past president of the National Foundation for Infectious Diseases, who also spoke at the press conference.

The CDC recommends that older adults not already vaccinated against pneumonia obtain the conjugate vaccine first, at the same time as their flu shot. “We’re encouraging doctors to stock it, and insurers have told us that they will reimburse for it,” Frieden said of the conjugate vaccine.

It makes sense for older adults to be immunized against pneumonia and flu at the same time because “getting influenza also increases a person’s chances of getting pneumococcal disease,” Schaffner said. “Influenza in and of itself is very bad, but it also leads to complications. One of those complications is pneumonia. Pneumococci bacteria are the leading cause of that pneumonia, and they can also cause pneumococcal meningitis and blood infections. These pneumococcal infections are particular deadly for older people….This makes it critical that everyone in the recommended age groups is protected against both diseases now that influenza season is approaching.”

People must wait six months to a year between receiving the conjugate vaccine for pneumonia and the polysaccharide vaccine. Those who already have received the polysaccharide vaccine can get the conjugate vaccine six months to a year afterward.

“You need to wait to maximize the immune response and also to minimize sore arms,” Schaffner explained.

The conjugate and polysaccharide vaccines are approved for use in adults aged 50 or more years. The polysaccaride vaccine also is approved for use in children aged at least two years if they are at increased risk for pneumococcal disease.

The CDC has posted pneumonia vaccination information on its website.

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