(Republished with permission from the St. Louis Post-Dispatch. This Lori Gets the Answers column originally ran on Monday, Jan. 8, 2007)
By Lori Shontz St. Louis Post-Dispatch
Q: I just heard of a shot you can take to keep from getting pneumonia. Do you know anything about this? And is pneumonia that big a problem? N.M., St. Louis County
A: In a word: Yes. According to the Centers for Disease Control and Prevention, Streptococcus pneumoniae causes 500,000 cases of pneumonia and 40,000 deaths a year, making it the No. 1 cause of infectious disease mortality among adults. In children, the bacteria is also responsible for many ear infections.
“This bacteria is a big problem,” says Dr. Steven Lawrence, assistant professor of medicine at Washington University School of Medicine. “It’s been one of the biggest infectious-disease problems that we’ve known about since we’ve known what bacteria are.”
Pneumococcal pneumonia can begin suddenly, with a “severe, shaking chill,” according to the National Institute of Allergy and Infectious Diseases. The most common symptoms that follow are high fever, cough, shortness of breath, rapid breathing and chest pain. Other potential symptoms are nausea, vomiting, headache, tiredness and muscle aches.
Two pneumonia vaccines are available — one for adults, the other for children.
The adult vaccine, Pneumovax, works against 23 of the serotypes of bacteria that cause pneumonia, about 85 percent of the total, Lawrence says. It’s a single-dose vaccine, given in an arm muscle.
“In particular,” he says, “it reduces the severe complications of pneumonia, like the bloodstream infections.”
The CDC recommends the vaccination for people age 65 or older, people with long-term health problems such as heart disease or sickle-cell disease and people with compromised immune systems (HIV or AIDS, lymphoma). The vaccine is “long-lasting,” Lawrence says, adding that people with compromised immune systems may need to get booster shots every five years.
“The country as a whole is doing better, but we still have room to improve in trying to get this to everybody over 65,” Lawrence says. “It’s fairly well-known in that age group.”
The vaccine for children, Prevnar, works against only seven of the pneumonia-causing bacteria, but those bacteria cause 80 percent of all infections, Lawrence says. Within the past five years, it has become more common, and it has been added to the childhood immunization schedule. Prevnar is administered in a series of four shots at ages 2 months, 4 months, 6 months and 12 to 15 months.
“It’s not known exactly how long it lasts, and as of now there are no recommendations for further boosting,” Lawrence says. “It lasts long enough to give very good protection during the highest-risk, early years.”
Lawrence says Prevnar has reduced serious infections by 97 percent. “The Pneumovax for adults isn’t quite as good, but it does reduce the complications and bloodstream infections much better than it prevents all pneumonia. It does prevent the really serious complications.”
Copyright 2007 St. Louis Post-Dispatch, Inc.