Bottom Line Inc

Two Pneumonia Vaccines? One is Fine, Thanks

0

It’s always nice when you can skip a visit to the doctor. It’s even better if you can avoid a shot, too.

When it comes to protecting yourself from pneumococcal disease, which can cause pneumonia, meningitis and sepsis, that’s exactly what two medical professors are suggesting.

They don’t think you should go in for two shots, even though that’s what the government recommends.

Who’s right—and how many shots will really protect you from pneumonia?

THE STORY OF THE EXTRA VACCINE

Since the 1980s, there’s been an effective vaccine against bacterial pneumonia, meningitis and sepsis, a life-threatening blood infection. It’s called PPSV23. A single dose protects against the 23 most common strains of pneumococcal disease, which is a serious disease that kills one in five people over 65 who get it. There’s no doubt that the vaccine is a lifesaver.

Who needs it? Any adult who has diabetes, heart disease, a chronic lung disease such as COPD or asthma, whose immunity is compromised, who smokes or who is an alcoholic—and every adult over age 65. It’s not an annual thing. If you’re 65, you just get it once.

So far, so good. But last year, the federal Centers for Disease Control and Prevention (CDC) upped the ante. They recommended that anyone who needs PPSV23 first get another, newer vaccine, PCV13, then wait six to 12 months, then go back to the doctor to get the tried-and-true one.

It’s true that PCV13 (the new one) boosts immunity a little extra. But there’s no evidence that it actually protects better against actual infection. The only research took place in the Netherlands, where most adults don’t get any pneumococcal vaccine, and it was tested only against a placebo.

So argue Michael Hochman, MD, MPH, medical director for innovation at AltaMed Health Systems in Los Angeles, and Pieter A. Cohen, MD, an assistant professor of medicine at Harvard Medical School. They are founding members of the “Slow Medicine” movement, which emphasizes “clinical reasoning, evidence-based practice, and the importance of lifestyle changes for improving health.” They believe that taking the extra vaccine is a needless cost and there’s no evidence that it will provide extra protection.

WHAT TO DO NOW

Insisting on both might also complicate the key goal—getting everyone who needs protection vaccinated. After all, about one-third of people who need the vaccine don’t get it at all—and that’s based on one visit, one shot.

Here’s what to do…

• Got two vaccines already? That’s fine. Neither doctor had a safety concern with either vaccine.

• Like the idea of extra protection, even if unproven? No worries—get the two.

• Want protection now without having to go back next year? Ask your doctor about just getting the proven, effective PPSV23 vaccine right away—and skipping the PCV13. Done and done.

Insurance note: Because the PPSV23 is approved for everyone over 65, your insurance plan should pay for it—even if you don’t get the PCV13 one first. But it never hurts to check.

print
Source: Editorial titled “LESS IS MORE: Reconsidering Guidelines on the Use of Pneumococcal Vaccines in Adults 65 Years or Older,” by Michael Hochman, MD, MPH, medical director of innovation, AltaMed Health Services, Los Angeles, and Pieter A. Cohen, MD, assistant professor of medicine, Harvard Medical School, Cambridge, Massachusetts, published in JAMA Internal Medicine. Date: November 23, 2015 Publication: Bottom Line Health
Keep Scrolling for related content View Comments