Q: I had my second pneumonia vaccine seven years ago at the age of 64. My family doctor says I don’t need another since I am over the age of 65. My hospital says people over 65 should get a follow-up shot every five years. So who is correct?
A: According to the Centers for Disease Control and Prevention (CDC), there are presently two types of pneumococcal vaccines available – PCV13 (pneumococcal conjugate vaccine) and PPSV23 (pneumococcal polysaccharide vaccine) that protects against, you guessed it, 23 strains. PCV is most commonly given to infants and young children who may have missed their immunization earlier. Those healthy children between the ages of two and four who have not been vaccinated or who have failed to receive the full series of four doses should receive one dose. Children between the ages of two and five with medical conditions that might include chronic heart or lung disease, sickle cell disease, a damaged spleen, HIV/AIDs or who have a compromised immune system and have not completed the full series should get one or two doses. Children 6 through 18 need direction from their pediatrician since specific medical conditions will call for one dose of PCV13 or a dose of PPSV23.
So, what is recommended for adults? According to the CDC, we never outgrow a need for vaccines. Those required by an adult are determined by such things as age, lifestyle, high-risk conditions such as working in a nursing home/hospital/adult day care center, the amount of travel done, and what immunization has been administered to date. All adults 65 and older who have not previously received PCV 13 should be vaccinated. Then between six to 12 months later, a dose of PPSV23 should be administered. You don’t indicate which vaccine you received, nor do you indicate if you have any medical issues that might come into play. If you have already received a dose of PPSV23, a dose of PCV13 should follow at least one year after you received the PPSV23. While you may be scratching your head at this one, essentially the CDC recommends one dose of PCV13 and one dose of PPSV23 for adults 65 or older – unless those adults have certain health conditions. Those are their guidelines and they are sticking to them.
The vaccines we received as children may protect us for a lifetime – providing we know which vaccines we received and immunity can fade as years pass by. We often become more susceptible to serious diseases such as pneumococcus. In fact, there were about 32,000 cases of invasive pneumococcal disease reported in 2012. This disease is serious and many of its strains are antibiotic resistant. Vaccination is available and is the best way to prevent the disease.
Adults over the age of 65 who receive the PPSV23 vaccine prior to the age of 65 should receive a booster shot if it has been more than five years since being vaccinated. Since you have had a 7-year interval and in accordance with the recommendation of the CDC, you are ready for a booster. You could not have been vaccinated against pneumococcal bacteria as a child because the vaccine wasn’t available until 2000; however, you should be guided by what your primary care physician who has access to your complete medical history has to say. The vaccine can be given at any time of year, is approved by Medicare and most insurances, and it is essentially painless.