Pneumococcal Vaccine

by Michael_Koger

Vaccination against pneumococcal infection is the most effective method to prevent that disease.

As of 2014, this vaccination has been available in 117 countries [2].

Two inactivated vaccines are available in the United States for protection against Streptococcus pneumoniae infection. The guidelines in that country recommend that adults take both of them in the elderly years as the two products are not identical. The schedule for the shots will vary, and this has to do with when the patient began the series [1, 2, 3].

Specifically, the variation will depend on whether the injections occur prior to, at, or after the age of 65. It will also depend on the presence or absence of immune system compromise and other serious medical conditions. In some regions of the world, vaccination begins at the age of 50 as this is officially the onset of elderly years [1, 2, 3].

The use of both vaccines generates a better antibody response than will one alone [1].

Two Vaccine Preparations

The vaccine preparations are pneumococcal polysaccharide vaccine-23 (PPSV23) and pneumococcal conjugate vaccine-13 (PCV13).  They both generate a B-cell-mediated immune response, but PCV13 is the only one which yields a T-cell-dependent response [1, 3].

Since the year 2000, PCV13 has been available in the United States for infants and children who are at least two months of age.  For adults, that same vaccine has been available since 2011.  The other one, PPSV23, provides protection for three to five years; however, it is not effective in infancy--the first two years of life [1, 2, 3].

Clearly, both are effective for adults as large studies in healthy people demonstrate.  All clients who are at least 65 years of age require both vaccines.  Moreover, individuals with immune system compromise or who do not have a spleen will benefit from both as well [1].

The list of medical conditions which place a patient at risk for invasive pneumococcal disease is quite long, but it includes absence of a spleen, human immunodeficiency virus infection, and other situations which may compromise the human defense system or place stress on the body

[1, 3].

Conclusion

The management of Streptococcus pneumoniae infection works best when infants, children, and adults take the vaccines to prevent it.  Schedules and recommendations for their use depend on age, immune system status, and the presence of other chronic medical conditions.  Nevertheless, there is much information available for patients and physicians to achieve the best possible outcome for everyone.

References

  1. Pallotta, A. and Rehm, S.  (2016).  Navigating pneumococcal vaccination in adults. Cleveland Clinic Journal of Medicine, 83, 427-433.
  2. World Health Organization.  (2016).  Immunization coverage.  Fact Sheet.  Retrieved July 4, 2016.
  3. Centers for Disease Control.  (2015).  Pneumococcal disease.  Retrieved July 4, 2016.
  4. The photo is a micrograph of Streptococcus pneumoniae from a blood culture.  Reprinted with permission from Centers for Disease Control/Dr. Mike Miller.

Disclaimer

The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.

Updated: 07/16/2016, Michael_Koger
 
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