Many of us have heard of vaccines. As children, we have all received our ‘shots’ that are meant to protect us from disease and illness.
Vaccines have evolved tremendously over the last couple of decades. These days, they are available to prevent a number of different clinical conditions. One such clinical condition is pneumonia.
Here, I will discuss what pneumonia is and why you should get yourself the pneumonia vaccine today. I have discussed pneumonia in adults here, and will be posting an article on pneumonia in children soon.
What Is A Pneumonia?
To put it very simply, pneumonia is a chest infection. However, it is not a mild one – it is usually quite serious.
The cause of a pneumonia is a bacterial organism called Streptococcus pneumoniae. However, there are a number of other organisms that can cause a pneumonia (like Hemophilus influenza B).
Typically, thick mucus secretions teeming with bacteria fill up the small air pockets in the lungs. These small pockets are called alveoli. When a large number of these alveoli are affected, a pneumonia results.
Pneumonia can affect anyone, though it seems to prefer only certain kinds of individuals. In the table below, I have listed those individuals who are at a high risk of developing a pneumonia.
1. Infants and children
2. Smokers
3. Individuals with lung disease such as asthma and chronic bronchitis
4. People with low immunity
5. Patients on immune suppressing drugs such as those used in cancer treatments
6. Adults over the age of 65 years
7. Immune lowering conditions such as HIV
8. Excessive alcohol intake
9. People taking long term antacid therapy (proton pump inhibitors)
10. Patients whose spleen has been removed
11. People living in care homes or college dorms
12. People with diabetes
A pneumonia is sometimes called a pneumococcal infection. The symptoms of the condition range from a simple cough to high fever, breathlessness and drowsiness.
The treatment of a pneumonia includes oxygen therapy, chest physiotherapy and high dose antibiotics given as an injection.
Serious cases often require admission to the Intensive Care Unit (ICU) for ventilation.
Why Should You Be Concerned?
According to the Center for Disease Control (CDC), around 18000 people over the age of 65 yrs die every year from a pneumococcal infection.
Their statistics are actually quite worrying, particularly the fact that they call it ‘deadly’. The CDC states that pneumococcal infections (pneumonia, meningitis) infections can be mild, but serious ones in people over the age of 65 years can kill one out of 20 people.
If the infection spreads to the blood (called bacteremia), it could kill 1 out of 6 people. If it spreads to the brain (meningitis), it could kill 1 out of 6 people as well.
In addition to this, a large and significant number of patients are admitted every year to hospital with a pneumonia.
The problem with the pneumococcal infection is that it does not just affect the lungs. It can also affect the brain (causing meningitis) and the spinal column.
There are no clear statistics in India that will help describe the scope of the problem. Most of the available data describes how common pneumonia is in children under the age of 5 years.
That being said, clinical data does suggest that around 30% of patients who suffer from a pneumonia succumb to it in India. That is just about 1 out of 3 patients! This is more common in the winter months in older patients and in smokers.
It is for this reason that the pneumococcal vaccine (pneumonia vaccine) is now recommended for adults.
The Pneumococcal Vaccine (Sometimes Called Pneumonia Vaccine)
As doctors, we are now thankful that a vaccine has emerged that can protect patients from deadly pneumococcal infections.
The pneumococcal vaccine comes in 2 different types –
- PCV13 (pneumococcal conjugate vaccine) – This protects against 13 strains of the pneumococcal organism
- PPSV23 (pneumococcal polysaccharide vaccine) – This protects against 23 strains of the pneumococcal organism.
In India, the commonly administered vaccine is the PPSV23.
Here are some questions about the vaccine that may come to your mind.
1. Who Should Take The Vaccine?
The pneumococcal vaccine is recommended for all people over the age of 65 years. For those below 64 years, it is advised for those who smoke or who have any underlying lung disease such as asthma or chronic bronchitis.
Broader indications include –
- Routine vaccination above 50 years
- Patients over the age of 2 years with a history of heart failure or lung disease
- Persons over 2 years with a history of alcoholism or liver disease (such as cirrhosis)
- People who have specific blood conditions such as sickle cell disease, or in those who do not have a spleen
- People with low immunity such as those with HIV, leukemia and lymphoma
- Patients with chronic kidney disease
- Post transplant patients
2. When Should The Vaccine Be Given?
The timing of the vaccine does not matter in healthy people above the age of 50 years, and can be taken anytime.
However, for those whose immunity is low or in those who are due to undergo chemotherapy for cancer, it is recommended the vaccine be taken at least 2 weeks prior to the treatment.
People with HIV should get the vaccine as soon as possible.
3. Do I Need A Booster Shot?
If you are normally fit and well and do not have any underlying medical condition, then the vaccine booster is not routinely recommended. If you are over 65 years at the time of your first shot, you will need a booster dose. Your doctor will advise you regarding that.
However, if your immunity is low for any reason or you suffer from some form of chronic lung disease, then you will need a booster pneumonia vaccine after 5 years.
Those who were under 65 years at the time of the vaccine and have crossed 65 within the 5 year period, then you will need a booster shot.
A third dose of the pnuemonia vaccine is not recommended as there is not sufficient data regarding this.
3. How Is The Vaccine Administered?
The pneumonia vaccine is administered as an injection. Each injection is around 0.5 mL.
The vaccine is injected just under the skin or into a muscle. It is not injected into a vein or blood vessel. Adequate precautions will be taken to ensure the vaccine is injected the right way.
4. Are There Any Side Effects?
Some patients may experience a slight soreness and redness at the site of the injection. A small amount of swelling due to water accumulation may be seen. This settles down within a day or 2.
Patients may notice a slight fever after the injection. If required, a dose of paracetamol may be taken.
In very rare cases, infection may occur at the site of injection. This may need antibiotic treatment.
5. How Effective Is The Vaccine?
Pneumococcal vaccines are very effective, and clinical studies have shown that. In fact, up to 85% of people who take the shot are completely protected.
However, rates do vary between individuals.
6. How Much Does It Cost?
The cost varies between company to company. The general costs per vaccine to the patient is between Rs 1400 to Rs 2000.
7. Can It Be Given With Any Other Vaccine?
Yes. The pneumonia vaccine can be given at the same time as the flu vaccine. Flu vaccine booster shots are required every year, unlike pneumococcal vaccines.
Closing Remarks
Pneumonia can be fatal if not treated in a timely manner. Prevention is obviously better than cure. Talk to your doctor about getting the pneumonia vaccine today.
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