What is pneumococcal disease?

Pneumococcal disease is caused by bacteria (Streptococcus pneumoniae) that can attack different parts of the body. The bacteria can cause serious infections of the lungs (pneumonia), the bloodstream (bacteremia) and the covering of the brain (meningitis).

Pneumococcal pneumonia is a serious illness, accounting for 10 percent to 25 percent annually of all pneumonias. Nationally, about 40,000 persons die as a result of pneumococcal pneumonia each year, but the illness is particularly dangerous for the very young, the elderly and persons with certain high-risk conditions. For example, among people 65 years of age and older with pneumococcal pneumonia, about 20 percent to 30 percent develop bacteremia. At least 20 percent of those with bacteremia die from it, even though they receive antibiotics.

Can pneumococcal pneumonia be prevented?

Yes, by getting vaccinated. The vaccine is safe, it works and one shot lasts most people a lifetime. People who get the vaccine are protected against almost all of the bacteria that cause pneumococcal pneumonia and other pneumococcal diseases as well. The cost of the shot is covered by Medicare.

Who should get the vaccine?

According to the National Institutes of Health, everyone 65 years of age and older should get the pneumococcal vaccine. Some younger people should get it, too.

Ask for the vaccine if you --

• are 65 years of age or older or care for someone 65 years of age or older,
• have a chronic illness, such as heart or lung disease or diabetes,
• have a weak immune system (caused by certain kidney diseases, some cancers, HIV infections, organ transplant medicines and other diseases), or
• are a resident or an employee of a nursing home or other long-term care facility.

There are two exceptions to children receiving the vaccine. First, since the vaccine is not effective in children younger than 2 years of age, shots will not benefit this age group. Second, in children who are otherwise healthy, frequent diseases of the upper respiratory system, including ear and sinus infections, are not considered reasons to use this vaccine.

When is the best time to get the vaccine?

For older individuals, some experts say it may be best to get the shot before reaching 65 years of age -- anytime after 50 years of age. They base this opinion on the fact that the younger you are, the better able your body is to mount a protective immune response. For those who receive an annual flu shot, the pneumococcal vaccine can safely be given at the same time.

Other adults and children who are at high risk of pneumococcal disease should consult their physicians. Generally, however, individuals who are scheduled for cancer chemotherapy or immunosuppressive therapy should wait at least two weeks after receiving pneumococcal vaccine to start therapy. The safety of pneumococcal vaccine for pregnant women has not been evaluated. Ideally, at-risk women should be vaccinated before they get pregnant.

Should a person who already has had pneumonia get the vaccine?

Experts agree that persons who already have had pneumonia can benefit from the vaccine. There are many kinds of pneumonia and having one kind does not insure immunity against the others. The vaccine protects against 88 percent of the pneumococcal bacteria that cause pneumonia. However, it does not guarantee that you will never get pneumonia, and it does not protect against viral pneumonia.

How often does a person need to be vaccinated?

Most people need to get the shot only once. However, some people may need a booster; check with your physician to find out if this is necessary for you.

Are there side effects?

About half of those who are given pneumococcal vaccine have very mild side effects, such as redness and pain at the injection site. Less than 1 percent of those getting the vaccine may develop fever, muscle aches and severe local reactions. Serious side effects, such as dangerous allergic reactions, have rarely been reported. As with any drug or vaccine, there is a rare possibility that allergic or more serious reactions or even death could occur. The pneumonia shot cannot cause pneumonia because it is not made from the bacteria itself but from an extract that is not infectious.