What’s good for the kids is good for grandma and grandpa, too, federal health officials have decided.
A vaccine that has been successful in stemming pneumonia in children (and the adults in their lives) is being pushed for older people. Prevnar 13 now is on the list of recommended vaccines for adults age 65 or older.
But it isn’t a replacement for the pneumococcal vaccine already routinely used in that population, meaning older people should get both shots, according to the federal Centers for Disease Control and Prevention.
The CDC’s Advisory Committee on Immunization Practices recommends that people 65 or older who have had no vaccine against pneumonia first receive PCV13 (Prevnar) and then 23-valent pneumococcal polysaccharide vaccine (Pneumovax).
The doses should be given six to 12 months apart. Those who already have received Pneumovax should get Prevnar a year or more after their most-recent Pneumovax shot. The committee had previously recommended using the vaccine in certain adults considered especially vulnerable to infection.
Complicating matters, at least in the short term, is the fact that Medicare currently is not paying for both vaccines and might not do so until 2016, said Dr. Brian Carlisle, a geriatrician at OhioHealth Grant Medical Center.
The cost of the newly recommended vaccine out of pocket is about $135 to $150, said Carlisle, who also works at OhioHealth’s John J. Gerlach Center for Senior Health. Older adults should talk to their primary-care physicians about how to proceed, he said.
Streptococcus pneumoniae (pneumococcus) causes various serious illnesses, including pneumonia, meningitis and sepsis, especially in older adults.
Children have been receiving Prevnar shots since 2000, significantly cutting infections in those kids and also in the adults in their lives.
From 2010 to 2013, the incidence of serious infections by strains in the most-current version of the vaccine were cut in half. (2010 saw the introduction of a second-generation shot for kids.)
Still, there were about 13,500 of those life-threatening cases in the United States among older adults in 2013, according to the CDC.
“We’ve seen a lot of success with immunizing our younger population. We’re hoping to get the same response in our elderly population,” Carlisle said.
Two recent studies in the United States and Europe show that Prevnar induced as good or better immune responses than Pneumovax, which already was recommended and includes 11 more viral strains than the newer vaccine. Federal health officials have said they recommend both to provide broad protection.
Too many older adults have been going without any protection, and an increased emphasis should be placed on getting them those vaccines to boost preventive care, said Dr. John Weigand, a Mount Carmel Health System physician who practices at Central Ohio Geriatrics in Granville.
“I think the most important thing is that they get an immunization,” he said. The new vaccine, “ is just another opportunity for us to talk to patients about prevention.”
Pneumonia becomes an increasingly life-threatening proposition as people age for a variety of reasons, including weakened immune systems, lungs that don’t work as efficiently and an increased incidence of chronic diseases.
Pneumovax is better at protecting against invasive infections, including bloodstream infections and meningitis, than protecting against pneumonia, said Dr. Shandra Day, an assistant professor of infectious disease at Ohio State University’s Wexner Medical Center.
Prevnar appears to be better at protecting against pneumonia itself, which is important, Day said. Side effects in studies so far have been limited and mostly include injection-site pain, she said. In some cases, people report fatigue after a shot.
About 90 percent of pneumococcal disease is in adults, and the worst cases are in those 65 or older, she said.
In the United States, about 30,000 cases of invasive pneumococcal disease are reported each year.
Source: The Columbus Dispatch
