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Pneumococcal Vaccine

Expert Interview: Dr. Poland on the Pneumococcal Vaccine

Facts about pneumococcal polysaccharide vaccine: Pneumococcal disease kills more people in the United States each year than all other vaccine-preventable diseases combined. The pneumococcal polysaccharide vaccine (PPV) protects against 23 types of pneumococcal bacteria. Most healthy adults who get the vaccine develop protection to most or all of these types within 2 to 3 weeks of getting the shot. Very old people, children under 2 years of age, and people with some long-term illnesses might not respond as well or at all.

Who should get PPV?

  • All adults 65 years of age or older.
  • Anyone over 2 years of age who has a long-term health problem such as:
    • heart disease
    • sickle cell disease
    • alcoholism
    • lung disease
    • diabetes
    • cirrhosis
    • leaks of cerebrospinal fluid
  • Anyone over 2 years of age who has a disease or condition that lowers the body's resistance to infection, such as:
    • Hodgkin's disease
    • kidney failure
    • nephrotic syndrome
    • damaged spleen, or no spleen
    • lymphoma or leukemia
    • multiple myeloma
    • HIV infection or AIDS
  • Anyone over 2 years of age who is taking any drug or treatment that lowers the body's resistance to infection, such as:
    • long-term steroids
    • radiation therapy
    • certain cancer drugs
  • Alaskan Natives and certain Native American populations.

How many doses of PPV are needed?

Usually one dose is all that is needed. However, under some circumstances a second dose may be given.

  • A second dose is recommended for those people aged 65 and older who got their first dose when they were under 65, if more than 5 years has passed since that dose.
  • A second dose is also recommended for people who:
    • Have a damaged spleen or no spleen
    • Have sickle-cell disease
    • Have HIV infection or AIDS
    • Have cancer, leukemia, lymphoma, multiple myeloma
    • Have kidney failure
    • Have nephrotic syndrome
    • Have had an organ or bone marrow transplant
    • Are taking medication that lowers immunity (chemotherapy, long-term steroids, etc.)

Children 10 years old and younger may get this second dose 3 years after the first dose. Those older that 10 should get it 5 years after the first dose.

What are the risks for patients from PPV?

About half of those who get the vaccine have very mild side effects, such as redness or pain where the shot was given. Less than 1% develop a fever, muscle aches, or more severe local reactions. Severe allergic reactions have been reported very rarely.

In the event of a moderate or severe reaction, physicians should ascertain the date and time of the reaction as well as when the vaccination was administered. Physicians should contact the Vaccine Adverse Event Reporting System (VAERS) at 1-800-822-7967 or on the web.

Additional information is available from the CDC on Pneumococcal.

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