Pneumococcal vaccine recommendations have been updated. Since 2014, the CDC has been recommending that adults ages 65 and older get two different vaccines for pneumonia, PCV13 (Prevnar 13), and six months to a year later, PPSV23 (Pneumovax). In November 2019, the CDC revised that recommendation, saying that not all people ages 65 and older need PCV13. Instead, the CDC advises older adults to decide with their doctors whether they still need PCV13.
Among those who typically should receive both PCV13 and PPSV23 are adults 19 and older who are at high risk for developing pneumococcal infections such as pneumonia, sepsis, and meningitis. They include those with:
- Cochlear implants
- A weakened immune system caused by conditions such as HIV/AIDS
- A bone marrow or organ transplant
- Immunosuppressive therapy from cancer treatments or drugs for immune disorders such as rheumatoid arthritis
- No spleen
- Cerebrospinal fluid leaks, which can be caused by a head injury; head, brain, or spinal surgery; a spinal tap; or placement of a tube for epidural anesthesia or pain medications
If you are 65 or older and have chronic heart, lung, or liver disease, diabetes, or alcoholism; smoke; or reside in a nursing home or other long-term care facility, you might benefit from PCV13 and should discuss your personal risk with your doctor.
PCV13 was developed in 2000 as a pneumococcal vaccination for infants and young children. In 2014, it began being offered as extra protection for older adults against 13 strains of the pneumococci bacteria—the cause of pneumonia and other infections—when coupledwith PPSV23. However, the pediatric immunization was so successful that it significantly lowered the risk of older adults getting infected from the strains covered in PCV13, which is why the vaccine is no longer needed for most people 65 and older.
What you should do
Discuss with your doctor whether you should consider PCV13. No matter what your decision, if you’re 65 or older, you still should get PPSV23. Because protection from PPSV23 can wane over time, your doctor may recommend a second dose five to 10 years after your first, depending on your health status, but Medicare may not cover the second shot.
This article first appeared in UC Berkeley Health After 50.
Also see Pneumonia: Causes and Treatments.