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Does My Child Need the Pneumonia Shot if She Has Asthma?

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Updated March 23, 2009

Question: Does My Child Need the Pneumonia Shot if She Has Asthma?

I took my child for a flu shot, but should she also get the pneumonia shot (pneumococcal vaccine)?

Answer:

Asthma is a risk factor for invasive pneumococcal disease in adults -- what the pneumonia shot protects against. And while pneumococcal disease is not as common as the flu, which you should protect your child against annually with a flu shot, an invasive pneumococcaal disease does have serious potential complications. Still, the CDC does not include kids in the list of individuals who should get the pneumonia shot.

Who Should Get the Pneumonia Shot: The CDC's Recommendations

In January 2009, the CDC updated its recommendation for the pneumococcal vaccine. Currently, there is no recommendation for kids with asthma. The recommendation states that 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, such as asthma
  • Immunocompromised or have a weakened immune system

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

A 2008 report cited an increased risk of invasive pneumococcal disease among patients with asthma. Patients with asthma were more likely to develop the following problems compared to patients without asthma:

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

In a similar study, asthma patients enrolled in Tennessee's Medicaid program Tenncare were more than 2 times as likely to develop invasive pneumococcal disease compared to non-asthmatics.

What Should I Do to Protect My Child?

These findings generally support the hypothesis that asthma is a risk factor for invasive pneumococcal disease in adults. The data do not currently suggest that kids are at similar risk as adults. Consequently, the recommendation for the pneumococcal vaccine in pediatric asthma patients has not changed.

You may want to discuss the risk with your healthcare provider and consider getting the pneumococcal vaccine for your child if you are concerned. Though this runs counter to the recommendations, the pneumococcal vaccine is safe and well-tolerated in kids. Since it is not considered 'necessary' for kids by the CDC, however, don't be surprised if your healthcare provider doesn't want to give it to your child, or if your insurance will not pay for it.

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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