Pneumococcal Disease and Flu

This is a bacterial infection cause by Streptococcus pneumoniae.The picture is an enlarged microscopic view of the villain, courtesy of the CDC.

We can encounter it is s_pneumoniaeone of several forms:

  • Pneumonia
  • Sinus infections
  • Ear infections
  • Meningitis
  • Bacteremia (blood stream infection).(1)

None of these are fun.

The most vulnerable are

  • Seniors age 65 and older
  • Young children, under age 2
  • Adults between the ages of 19 and 65 with COPD, other chronic disease affecting breathing or who smoke
  • And those involved in international travel.

There are two vaccines for this disease, that are to be taken in sequence:

  • Pneumococcal Conjugate (PCV13), followed by
  • Pneumococcal Polysaccharide (PPSV23). (2)

The interval for administration between the first and second started as 8 weeks for those age 19 and older, but has been revised twice since.  The current recommendations are at https://www.cdc.gov/vaccines/vpd/pneumo/hcp/who-when-to-vaccinate.html.

The CDC recommends that everyone in these age groups be vaccinated, as well as persons between age 19 and 65 with certain medical conditions or who smoke.

A new research report in the Journal of the American Board of Family Medicine indicates that while Primary Care Physicians (PCPs) are aware of the disease, many are uncertain about the vaccination recommendations. This research was prompted by the observation that only 65% of seniors and 23% of at-risk younger adults have received vaccination.(3)

This isn’t the same as the vaccination for flu. The question is whether the lack of vaccination for this bacterial infection has contributed to the deaths in this flu season.

Apparently, that was the case in 2009 with the N1H1 flu strain.(4)

There are several papers from different authors arguing that these vaccines should be administered to seniors and those with COPD or other chronic lung diseases in additional to the annual flu vaccine.(5 and 6)


Sources:

  1. https://wwwnc.cdc.gov/travel/diseases/pneumococcal-disease-streptococcus-pneumoniae
  2. https://www.cdc.gov/vaccines/vpd/pneumo/index.html
  3. https://www.medscape.com/viewarticle/891904?nlid=120442_3381&src=wnl_mdplsnews_180202_mscpedit_wir&uac=153634BV&impID=1549417&faf=1
  4. https://www.cdc.gov/h1n1flu/pneumococcal.htm
  5. Shawn Gilchrist et. al., “Benefits and Effectiveness of Administering Pneumococcal Polysaccharide Vaccine With Seasonal Influenza Vaccine: An Approach for Policymakers,” American Journal of Public Health, v.102(4); Apr 2012, PMC3489371. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3489371/
  6. Filipe Froes et. al., “Pneumococcal vaccination and chronic respiratory diseases,” International Journal of Chronic Obstructive Pulmonary Disease, 2017; 12: 3457–3468.

 

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