What do Bob Hope, Fred Astaire, James Brown and Jim Henson have in common?
They all died as a result of pneumonia.
Most people are not all that surprised when they hear of an older individual dying of pneumonia, even if they are celebrities. In fact, it is often called “the old man’s friend” because the inflammation that occurs in the lungs as a condition of pneumonia can often shorten the suffering of those who are already close to death.
However, even in a well developed country like the United States, with all our advanced medical care, pneumonia is still one of the most common types of pneumococcal disease there is, infecting about 900,000 Americans each year and resulting in as many as 400,000 hospitalizations. But it’s not just old people who die of pneumonia. The truth is, pneumococcal disease doesn’t really discriminate. As many as 7% of people who contract pneumococcal pneumonia will die and this disease infects the young, the old, the healthy, the sick, the poor and the wealthy.
This is why vaccines are such an important preventive measure in the fight against pneumococcal disease.
Fortunately, there are vaccines to prevent certain types of pneumonia, and that’s a good thing considering there are more than 90 types of pneumococcal bacteria. While it is not possible to include all of the 90 different serotypes into one pneumococcal vaccine, the two vaccines that are available and approved for use in the U.S. protect against the serotypes that are most likely to cause invasive disease.
By invasive disease we mean the serious diseases that can occur when the bacteria invades parts of the body that are normally free of germs. See, besides pneumonia, pneumococcus can also cause other types of infections too. Some are less severe, like ear and sinus infections, while others are much more severe and invasive such as bacteremia, which occurs when there is an infection in the bloodstream, and meningitis, which occurs when the bacteria invades the tissues and fluids surrounding the brain and spinal cord. When invasive pneumococcal diseases occurs, it is usually very severe, requiring treatment in a hospital and often causing death.
As recent as 2013, there were an estimated 3,700 deaths in the U.S. from pneumococcal meningitis and bacteremia and 90% of these invasive cases occurred in adults. There are also about 2,000 cases of serious pneumococcal disease in children under the age of five in the U.S. each year.
Unfortunately, despite the availability of effective vaccines, an examination of the “State of the ImmUnion” reveals that we are not as prepared as we could be here in the U.S..
We know that most pneumococcal deaths in the U.S. are in adults, yet 67 million adults remain at risk because they are unvaccinated.
The Healthy People 2020 goal is to achieve at least 90% coverage for pneumococcal polysaccharide vaccine among persons 65 years of age and older. However, data from 2005 indicates that only 64% of persons 65 years of age or older had ever received pneumococcal polysaccharide vaccination and coverage levels were even lower among those 18-64 years of age who are recommended to be vaccinated due to a chronic illness.
Unfortunately, opportunities to vaccinate high-risk persons are often missed and effective programs are needed to offer vaccines at hospital discharge, during visits to clinicians’ offices, in nursing homes and in other long-term care facilities.
Vaccination is the safest and most effective way to prevent pneumococcal disease, but with two different vaccines, each recommendation at different ages, it’s easy for people to get confused.
So here are the two types of pneumococcal vaccines approved for use in the U.S., and who they are recommended for:
- The pneumococcal conjugate vaccine (PCV13 or Prevnar 13®) protects against the 13 most common types of pneumococcal bacteria that cause most of the severe illness in children and adults.
This vaccine is recommended for infants and children in the first two years of life, for all adults 65 years or older, and for certain others with conditions that weaken their immune system such as HIV infection, organ transplantation, leukemia, lymphoma, and severe kidney disease. The primary series beginning in infancy consists of three doses routinely given at 2, 4, and 6 months of age with the fourth (booster) dose recommended at 12–15 months of age.
- The pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax 23®) protects against 23 types of pneumococcal bacteria.
This vaccine is not used in infants or toddlers under the age of two because the polysaccharide antigens are poorly immunogenic in such individuals. Rather, this vaccine is given to adults 65 years or older, as well as children and younger adults with certain high-risk conditions. It is also recommended for adults 19 through 64 years old who smoke cigarettes or who have asthma due to increased risk of invasive pneumococcal disease among these groups.
While cases of pneumonia may seem rather common, we should not underestimate the dangers of pneumococcal disease.
Make sure that you and your family are up-to-date on the recommended vaccines. Sadly, people like Shannon Duffy Peterson have had personal experiences with pneumococcal disease that they wish had never happened. In the PKIDs video below, Shannon talks about losing her daughter Abigale, just days before her sixth birthday. While the nurse in the video is explaining the dangers of the disease, Shannon gives a heartfelt testimony of her experience and explains that her family doctor convinced her that vaccination was not necessary for her otherwise healthy daughter.
The Peterson’s story is a powerful one, and we hope it will help emphasize how unpredictable pneumococcal disease can be to people of all ages.