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Your Guide To Adult Vaccines

5 Reasons to Get a Pneumococcal Vaccine

It targets infections like pneumonia and meningitis and is recommended for adults 65 and older

Doctor treating a female pneumonia patient with a breathing machine

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Headed to the doctor’s office or pharmacy this fall to get your annual flu shot or updated COVID-19 booster? Don’t forget about another vaccine that’s critical for older adults to receive — one that protects against pneumococcal disease. 

Funny-sounding name aside, pneumococcal disease is serious business. According to the Centers for Disease Control and Prevention (CDC), approximately 10 percent of all patients with invasive pneumococcal disease die of their illness. In fact, excluding COVID-19, pneumococcal disease kills more people in the U.S. each year than all other vaccine-preventable diseases combined, and older adults are among those at higher risk for some of these its more severe outcomes. 

What is pneumococcal disease? It’s an umbrella term for any infection caused by the Streptococcus pneumoniae bacteria — pneumonia and meningitis are a few examples. This bacteria spreads when respiratory sections (think: saliva or mucus) are sent through the air by coughing or sneezing and are then inhaled.

Streptococcus pneumoniae are particularly lethal for the lungs and can potentially lead to pneumococcal pneumonia, the most common type of pneumonia the U.S. An estimated 150,000 Americans are hospitalized with this illness each year, and it kills about 1 in 20 of those infected.

Even with appropriate antibiotics, pneumococcal pneumonia, “particularly in people 65 and older,” has a high case-fatality rate, notes Gregory Poland, M.D., director of the Mayo Clinic’s Vaccine Research Group.  A big reason: As we age, the immune system becomes less able to fight off infections.

But studies show the pneumococcal vaccine — which is recommended for adults 65 and older and for individuals with certain medical conditions — can help to lower your chances of contracting the disease, or reduce its severity if you do get it, possibly saving you from a stint in the hospital, even death.

That, alone, is a good reason to get the vaccine once you’re eligible. Here are five others:  

1. It’s flu season

Flu season is upon us, and experts are expecting this year to be a particularly rough one. That matters because “pneumococcal pneumonia can follow other viral infections, particularly influenza,” notes, William Schaffner, M.D., an infectious disease specialist at the Vanderbilt University School of Medicine. 

Here’s how: The flu virus attaches to, and infects, the cells lining the mucous membranes in the back of the throat and nose. Normally, the cells eject infectious agents out of the body via the nose or mouth, or they’re simply swallowed. But when impaired by the flu, the cells lining these membranes allow bacteria to slip down into the bronchial tubes and trigger a secondary infection in the lungs.

The infection inflames the air sacs in the lungs and causes them to fill with pus and fluid, making it harder to breathe and triggering a whole host of other unpleasant symptoms.

— The flu shot — and the CDC now recommends that adults 65 and older opt for a high-dose version over the standard variety — can reduce your likelihood of experiencing this dangerous dual flu-pneumonia infection. So can the pneumococcal vaccine, which unlike the flu shot, isn’t given on an annual basis. For most, one jab will do it, although some adults (those who receive what’s known as PCV15) require two.

That said, if you’re going in for your flu shot and are eligible for your pneumococcal vaccine, the CDC says you can get them at the same time.

2. It can help prevent very serious infections throughout the body

Your lungs aren’t the only part of the body vulnerable to pneumococcal infections. Those pathogens can invade other areas, as well.

“Bacterial infections, by their nature, are dirty infections — they are bugs in our system,” says Ian Neel, M.D., associate clinical professor and medical director in the Division of Geriatrics and Gerontology at UC San Diego Health. “If left untreated, or if part of a particularly virulent strain, they typically take hold in a specific site — the lungs, for example. If they expand too much, they can get into other surrounding tissues and can move into our bloodstream. And if it’s in our bloodstream, it can get spread throughout our body, which can be catastrophic.”

To say the least. Pneumococcal infections can lead to sepsis, which is an aggressive inflammatory response that can ultimately result in organ failure and death. In rarer cases, the infection can pass through the brain barrier and cause meningitis.

3. It might protect your ticker

Heart disease is the leading cause of death in the U.S., but the pneumococcal vaccine may have a protective effect on cardiovascular events in adults.

A meta-analysis of 18 studies, with over 700,000 participants, found the 23-valent polysaccharide pneumococcal vaccine (PPV23) provided protection from some cardiovascular events — specifically a heart attack — in people who were vaccinated, particularly those age 65 years and older.

“One of the things we have learned about the germs that cause inflammation in our bodies — these influenza and pneumococcal organisms — is that even after we recover from the acute illness, the inflammation persists for a while and can put us at increased risk of a heart attack,” Schaffner says.

4. It may benefit your brain

While more studies are needed, promising research suggests that the pneumococcal vaccine may also be associated with a reduced risk of developing Alzheimer’s disease. A team of researchers from Duke University reviewed the medication records of more than 5,000 adults 65 and older to seek out a link between the pneumococcal vaccination and the risk of Alzheimer’s disease.

They found that people who received the pneumococcal vaccine between ages 65 and 75 had a reduced risk of developing Alzheimer’s disease later in life by as much as 40 percent. The results were presented at the 2020 Alzheimer’s Association International Conference alongside other research that also linked the influenza vaccine to a lower risk of dementia. 

“Vaccinations against pneumonia before age 75 may reduce Alzheimer’s risk later in life, depending on [genetic makeup],” study author Svetlana Ukraintseva said in a news release. “These data suggest that pneumococcal vaccine may be a promising candidate for personalized Alzheimer’s prevention, particularly in non-carriers of certain risk genes.”

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5. Pneumonia can be sneaky

Many people, children in particular, can have this bacteria in their nose or throat and not display any symptoms, since their immune system stops the germs from moving to another part of the body. However, they can still transmit the disease to others. What’s more, symptoms of pneumonia — including fever, difficulty breathing, chest pain, and coughing up phlegm or mucus — make it easy to mistake for merely a stubborn cold or a bout flu. But unlike with the cold or flu, antibiotics are often needed to treat pneumococcal pneumonia.

What to know about the pneumococcal vaccine

Who needs it: The CDC recommends pneumococcal vaccines for adults ages 65 and older and for individuals 19 to 64 who have certain medical conditions that put them at increased risk.

Which one to get: Four different types of pneumococcal vaccines are on the market, but the CDC recommends PCV15 or PCV20 for adults 19 and older who get vaccinated. Just know that if you get PCV15, it should be followed by the PPSV23 vaccine at least one year later. (This can be shortened to eight weeks when a patient has an immunocompromising condition.) If you’ve received a pneumococcal vaccine in the past but never completed your series, ask your health care provider which shot you should receive.

How well do they work? Because PCV15 and PCV20 are new vaccines, there isn’t any data to show how well they work in real-world conditions. That said, these vaccines were approved because clinical trial data indicate they cause an immune response similar to PCV13, according to the CDC. And studies show PCV13 conveys strong protection against serious pneumococcal infections in older adults.

Why you need it: Pneumococcal pneumonia leads to approximately 150,000 hospitalizations each year in the U.S., CDC statistics show. Young children and those over 65 have the highest incidence of serious illness, and older adults are more likely to die from it.

Barbara Stepko is a longtime health and lifestyle writer, and former editor at Women’s Health and InStyle. Her work has appeared in The Wall Street Journal, Parade and other national magazines.

Editor's note: This story, originally published October 26, 2020, has been updated to include new information.