Adult vaccination and the pneumococcal pneumonia vaccine

Featuring Dr. Daniel Ngui, BSc.(P.T), MD, CFPC, FCFP, Family Physician

Duration: 4 minutes, 9 seconds

Immunization through all stages of life is very important, but adult immunization in particular is something of interest. Adult immunization is important to talk to your primary healthcare provider about because not all infectious diseases have been eradicated.

In fact, we think that because of the emergence of antibiotic resistance, treating simple conditions such as pneumonia is much harder as our antibiotics don’t work. Some vaccines don’t last a lifetime, and so for example a tetanus shot needs to be repeated every 10 years.

As well, patients getting immunized as adults can help those at highest risk. Those who are young, those who are elderly and those who are immunocompromised can get infections. And if adults get immunized when they’re healthy, it can help with herd immunity or reduce the risk to transmit these conditions to others.

Pneumococcal pneumonia is a bacterial infection, and very similarly to a cough, or a cold or a flu, this type of infection can be spread via the air. Airborne droplets when someone coughs or sneezes, or if there’s secretions that someone comes into contact to, these are the methods in which you can acquire a pneumococcal infection.

When you have a pneumococcal infection, what we’re worried about is invasive pneumococcal disease. That means when the infection goes into your bloodstream and causes a bacteremia or bloodborne infection. It can also enter into our nervous system and we can have meningitis. And finally, what we also know is that pneumococcal infections can cause bad pneumonia.

Having invasive pneumococcal disease is actually a very dangerous situation. One in 14 Canadians could die if they have an infection. In other words, the case fatality rate is between 5 to 7 percent once you have invasive pneumococcal disease. So speaking to your primary care provider and asking them how can you prevent this important illness would be a priority for all patients.

Who should get immunized? Well the National Advisory Committee on Immunization have come up with a list, or some categories, of who should be thinking about adult immunization with pneumococcal vaccination.

So there are some categories, such as anyone over age 65. Perhaps you can also be under 65, and you can live in a long-term care facility. If you’re immunocompromised, or you have special conditions which require immunization against pneumococcal infections.

Some of those examples include diabetes, chronic lung disease such as asthma or COPD. People who struggle with alcohol misuse disorder, or alcoholism, or those who are homeless, or those who live in institutions. These are simple examples of people who might want to speak to their primary care provider about pneumococcal vaccination.

What will happen when you see your primary care provider and you ask them about pneumococcal vaccination? First of all, they’ll tell you there are two types of vaccines for pneumococcal infections. One is Pneumo 13, and one is Pneumo 23. Thirteen strains versus 23 strains of protection.

The second thing that your primary care provider will tell you about, is the fact that the coverage will differ, and the timing will differ. For example, if you get the vaccine against 13 strains of pneumonia first, you can actually get the second vaccine for Pneumo 23 after 8 weeks, however, if the situation was reversed and you happen to have the vaccine for 23 strains first, you might actually have to wait one year before you could have the vaccine for pneumococcal infection against 13 strains.

Today we discussed some general ideas and comments about adult immunization as well as pneumococcal vaccination. Every patient is different, and every patient has different situations. If you have further questions, speak to your primary care provider about what’s right for you when it comes to pneumococcal vaccination.

Presenter: Dr. Daniel Ngui, Family Doctor, Vancouver, BC

Local Practitioners: Family Doctor