Each year in the United States, pneumococcal disease kills thousands of adults, including 18,000 adults 65 years or older. Thousands more end up in the hospital because of pneumococcal disease. Pneumococcal disease can cause severe infections of the lungs (pneumonia), bloodstream (bacteremia), and lining of the brain and spinal cord (meningitis). The best way to prevent pneumococcal disease is by getting vaccinated.
There are two vaccines that can prevent pneumococcal disease: PCV13 (pneumococcal conjugate vaccine) and PPSV23 (pneumococcal polysaccharide vaccine). PCV13 protects against 13 strains of pneumococcus bacteria and PPSV23 protects against 23 strains of pneumococcus bacteria. Both vaccines provide protection against illnesses like meningitis and bacteremia. PCV13 also provides protection against pneumonia.
These vaccines are safe, but side effects can occur. Most side effects are mild, such as arm swelling or soreness, and do not affect daily activities.
PCV13 is recommended for all adults 65 years or older, adults 19 years or older with certain health conditions, and adults 19 years or older who are taking medications that lower the body's resistance to infection (immunocompromised). Anyone who has ever had a life-threatening allergic reaction to a dose of the vaccine, to an earlier pneumococcal vaccine called PCV7 (or Prevnar), or to any vaccine containing diphtheria toxoid (for example, DTaP), should not get PCV13. Anyone with a severe allergy to any component of PCV13 should not get the vaccine.
PPSV23 is recommended for all adults 65 years or older, adults 19 years or older with certain health conditions or who smoke cigarettes, and adults 19 years or older who are immunocompromised. Anyone who has ever had a life-threatening allergic reaction to a dose of PPSV23 or with a severe allergy to any component of the vaccine should not get the vaccine.
The CDC recommends the two pneumococcal vaccines for all adults 65 years or older. A patient should receive a dose of PCV13 first, followed by a dose of PPSV23, at least 1 year later. If the patient has already received doses of PPSV23, the dose of PCV13 should be given at least one year after receipt of the most recent PPSV23 dose. If the patient has already received a dose of PCV13 at a younger age, another dose of PCV13 is not recommended.
PCV13 and PPSV23 should not be given at the same time. When both vaccines are recommended, the patient should receive a dose of PCV13 first, followed by a dose of PPSV23 at another visit. The patient should consult a healthcare professional to find out when to receive the second vaccine.
The patient can get either pneumococcal vaccine (but not both) when the patient gets the influenza (flu) vaccine. While the patient does not need a pneumococcal vaccine every year, it is important to get a flu vaccine each flu season because having the flu increases the chances of getting pneumococcal disease.
Most private health insurance policies cover pneumococcal vaccines. Check with the insurance provider for details on whether there is any cost and for a list of in-network vaccine providers. Medicare Part B also covers 100% of the cost for both pneumococcal vaccines (when administered at least one year apart).
Pneumococcal vaccines may be available at private doctor offices, public or community health clinics, or pharmacies. Check with a doctor or pharmacist or use the Adult Vaccine Finder to help find places that provide pneumococcal vaccines.
Most pneumococcal infections are mild. However, some can be deadly, especially for adults 65 years or older:
- Pneumococcal pneumonia kills about 1 out of 20 who get it.
- Pneumococcal bacteremia kills about 1 out of 6 who get it.
- Pneumococcal meningitis kills about 1 out of 6 who get it.
Pneumococcal disease is an infection caused by Streptococcus pneumoniae bacteria, also known as pneumococcus. Pneumococcal bacteria can cause many types of illnesses that range from mild to very severe. When pneumococcal bacteria spread from the nose and throat to ears or sinuses, it generally causes mild infections. Pneumococcus bacteria causes up to half of middle ear infections (otitis media). Pneumococcal bacteria spread from person to person by direct contact with respiratory secretions, like saliva or mucus. People can carry the bacteria in their nose and throat, and can spread the bacteria without feeling sick.
When the bacteria spread into other parts of the body, it can lead to severe health problems such pneumonia, bacteremia, and meningitis. These illnesses can be life threatening, especially for adults 65 years or older, people with chronic health conditions, and people who are immunocompromised. Pneumococcal disease can lead to disabilities like deafness, brain damage, or loss of arms or legs.
Pneumococcal pneumonia (lung infection) is the most common serious form of pneumococcal disease. Symptoms include fever and chills, cough, rapid breathing or difficulty breathing, and chest pain. Older adults with pneumococcal pneumonia may experience confusion or low alertness, rather than the more common symptoms listed above.
Pneumonia is an infection of the lungs that can cause mild to severe illness in people of all ages. Complications of pneumococcal pneumonia include infection of the space between membranes that surround the lungs and chest cavity (empyema), inflammation of the sac surrounding the heart (pericarditis), and blockage of the airway that allows air into the lungs (endobronchial obstruction), with lung collapse (atelectasis) and collection of pus (abscess) in the lungs. About 5 out of 100 people with non-invasive pneumococcal pneumonia will die from it, but that rate may be higher among elderly patients. Pneumococcal pneumonia is considered non-invasive if there’s not bacteremia or empyema occurring at the same time.
Pneumococcal meningitis is an infection of the covering of the brain and spinal cord. Symptoms include stiff neck, fever, headache, pain when looking into bright lights, and confusion. In babies, meningitis may cause poor eating and drinking, low alertness, and vomiting. Meningitis is the most severe type of invasive pneumococcal disease. Of children younger than five years old who get pneumococcal meningitis, about 1 out of 15 dies of the infection and others may have long-term problems, such as hearing loss or developmental delay. The chance of death increases among elderly patients.
Pneumococcal bacteremia and sepsis are blood infections. Symptoms include fever, chills, and low alertness. Bacteremia is a type of invasive pneumococcal disease that infects the blood. About 1 out of 100 children younger than 5 years old with this blood stream infection die of it. The chance of death increases among elderly patients.
Each year in the United States, pneumococcal disease causes thousands of infections, such as meningitis, bloodstream infections, pneumonia, and ear infections. Pneumococcal vaccines are very good at preventing severe disease, needing treatment in the hospital, and death.
See the CDC Report
See also Medical Law Perspectives, March 2014 Report: Blood Draws, Testing, Transfusions: Venipuncture Injury, Inaccurate Results, Tainted Blood - The Liability Risks
See also Medical Law Perspectives, January 2013 Report: Vaccines: An Ounce of Prevention May Lead to a Pound of Injury
See also Medical Law Perspectives, January 2012 Report: Hospital-Acquired Infections: Who Is Liable and Why?