Prevention Of Pneumococcal Infections Secondary To Seasonal And 2009 H1N1 Influenza

October 23, 2009, 4:30 PM ET

• What is Pneumococcal Disease?
• What are the Symptoms of Pneumococcal Disease?
• Why is Prevention of Pneumococcal Disease Important during Influenza Season?
• How Can High-Risk Individuals Protect Themselves from Pneumococcal Disease?
• Who should get Pneumococcal Polysaccharide Vaccine (PPSV)?
• Can Adults get Pneumococcal (PPSV) and Influenza Vaccines at the Same Time?
• Is the Pneumococcal Vaccine (PPSV) Safe?
• Related Links

What is Pneumococcal Disease?

Pneumococcal disease is an infection caused by a type of bacteria called Streptococcus pneumoniae (pneumococcus). When these bacteria invade the lungs, they can cause pneumonia. They can also invade the bloodstream (bacteremia) and/or the tissues and fluids surrounding the brain and spinal cord (meningitis). Pneumococcal infection kills thousands of people in the United States each year, most of them 65 years of age or older.

What are the Symptoms of Pneumococcal Disease?

The symptoms of pneumococcal pneumonia include fever, cough, shortness of breath, and chest pain. The symptoms of pneumococcal meningitis include stiff neck, fever, mental confusion and disorientation, and visual sensitivity to light (photophobia). The symptoms of pneumococcal bacteremia may be similar to some of the symptoms of pneumonia and meningitis, along with joint pain and chills.

Why is Prevention of Pneumococcal Disease Important during Influenza Season?

Influenza infections can make people more likely to develop bacterial pneumonia.  Pneumococcus is the most common cause of bacterial pneumonia. Pneumococcal infections are a serious complication of seasonal and 2009 H1N1 influenza infections and can cause death.

How Can High-Risk Individuals Protect Themselves from Pneumococcal Disease?

There is a vaccine to protect high-risk individuals 2 through 64 years of age against serious pneumococcal disease. The vaccine, pneumococcal polysaccharide vaccine (PPSV), is safe and effective. Most people need a single dose of the pneumococcal vaccine in a lifetime. All children less than 5 years of age should receive a different vaccine called pneumococcal conjugate vaccine (PCV7); high risk children 2 to 4 years of age need both pneumococcal vaccines. 

Who should get Pneumococcal Polysaccharide Vaccine (PPSV)?

Approximately 70 million people who should be receiving PPSV are not yet vaccinated (National Health Interview Survey, 2007). View chart showing who is not yet vaccinated.

PPSV is recommended for:

• People who are 65 years of age and older
• People 2 years of age and older who have a chronic illness such as:
• cardiovascular or lung disease
• sickle cell disease
• diabetes
• alcoholism
• chronic liver disease
• cerebrospinal fluid (CSF) leak
• a cochlear implant
• People 2 years of age and older with a weakened immune system
• Due to illnesses such as:
• HIV infection
• AIDS
• chronic renal failure
• nephrotic syndrome
• organ or bone marrow transplantation
• Hodgkin’s disease
• leukemia
• lymphoma
• multiple myeloma
• generalized malignancy
• Those receiving immunosuppressive therapy (e.g., steroids)
• Those who have had their spleen removed or whose spleen is dysfunctional due to an illness such as sickle cell disease.
• Residents of nursing homes or long-term care facilities
• People 19 through 64 years of age who smoke cigarettes or have asthma.

During the 2009-2010 influenza season, vaccinating people 2 through 64 years of age who have the above risk conditions is most important because people in this group may be more likely to develop secondary bacterial pneumonia after an influenza infection.

Healthy persons less than 65 years of age are not recommended to receive PPSV. 

Can Adults get Pneumococcal (PPSV) and Influenza Vaccines at the Same Time?

Yes, pneumococcal vaccine may be given at the same time as influenza vaccine. Pneumococcal vaccine can be given at any time during the year. Because the adult groups for whom pneumococcal and seasonal influenza vaccines are recommended are similar, the need for pneumococcal vaccination should be evaluated at the time of annual influenza vaccination. The need for pneumococcal vaccination should also be evaluated at the time of 2009 H1N1 influenza vaccination. Persons who cannot remember if they’ve ever had pneumococcal vaccine should still be vaccinated.

During the 2009-2010 influenza season, work with your healthcare provider to determine when you can get your pneumococcal, seasonal influenza, and 2009 H1N1 influenza vaccines.

Is the Pneumococcal Vaccine (PPSV) Safe?

The pneumococcal vaccine is considered safe. Some people experience mild side effects, but these are usually minor and last only a short time. When side effects do occur, the most common include swelling and soreness at the injection site. A few people experience fever and muscle pain. Anyone who has a severe allergy to any component of the vaccine should not get that vaccine. As with any medicine, there are very small risks that serious problems could occur after getting the vaccine. However, the potential risks associated with pneumococcal disease are much greater than the potential risks associated with the pneumococcal vaccine. You cannot get pneumococcal disease from the vaccine. 

Ask your healthcare provider if you should delay receiving the pneumococcal vaccine if you have an illness with fever or other active infection.