Pneumonia Shot Reccomended For Adult Asthmatics

Getting shots is no fun and you have had your flu shot, but should you get the pneumonia shot or pneumococcal vaccine as well?

Evidence To Support Recommendation Was Lacking

A 2008 Cochrane Review entitled Pneumococcal Vaccine for Asthma stated there was limited information to support vaccination of asthmatics with the pneumococcal vaccine based on available evidence from randomized controlled trials. However, The U.S. Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) subsequently voted in October 2008 to recommend the vaccination for all patients with asthma over the age of 18. Why the sudden change?

New Research

This new recommendation was partially based on research reports indicating asthmatics were at increased risk of pneumococcal infections:

• Juhn et. al. reported in 2008 an increased risk of invasive pneumococcal disease among patients with asthma. Patients with asthma were found to have more of the following problems compared to patients without asthma:


• Sepsis and bacteremia- significant infections in your blood stream
• Meningitis- an infection of the tissue surrounding your brain
• Pneumonia- a lung infection
• Osteomyelitis- an infection of bone


• In a similar study Talbot et. al found that patients enrolled in Tennessee's Medicaid program Tenncare with asthma were more than 2 times as likely to develop invasive pneumococcal disease compared to non-asthmatics.

What Should I Do

These findings generally support the the hypothesis that asthma is a risk factor for invasive pneumococcal disease. In January 2009, the Centers for Disease Control updated its recommendation for the pneumococcal vaccine. The recommendation states you should receive the pneumococcal vaccine if you are:

• Over the age of 65
• Between the ages of 18 and 65 and have a chronic heart or lung condition like asthma
• Immunocompromised or have a weakened immune system

You may want to discuss with your healthcare provider and consider getting the pneumococcal vaccine.

What About My Child With Asthma

The current data focuses only on adults. Because there was not enough pediatric data, there was no change in the recommendation for children with asthma to receive the polysaccharide pneumococcal vaccine. Thus, the pneumococcal vaccine is not currently recommended for children. It is important to realize this vaccine is different from the conjugate pneumococcal vaccine all children should receive in the first 2 years of life.

What Do you Think

Why not go to the forum contribute to the discussion. What do you think about getting the 'pneumonia shot?'

Sources:

T.R. Talbot, T.V. Hartert, E. Mitchel, N.B. Halasa, P.G. Arbogast and K.A. Poehling et al. Asthma as a risk factor for invasive pneumococcal disease. NEJM 2005 352: 2082–2090.

T.V. Hartert. Are persons with asthma at increased risk of pneumococcal infections, and can we prevent them? J Allergy Clin Immunol 122 (2008) 724–725

Y.J. Juhn, H. Kita, B.P. Yawn, T.G. Boyce, K.H. Yoo and M.E. McGree et al. Increased risk of serious pneumococcal disease in patients with asthma. J Allergy Clin Immunol 122 (2008) 719–723.

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