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Preventive Health Care

 

Pneumococcal Vaccine

 

Mark E. Pierce, MD. January 16 , 2009

 

Pnuemococcus is a gram positive bacteria responsible for causing pneumonia, meningitis, ear infections, sinus infections and sore throats. There are over 80 wild strains. The adult vaccine include 23 of the most common serotypes causing infection. The childhood vaccine released in the year 2000 has 7.

 

Pneumococcal pneumonia is characterized by its sudden onset, rapid progression, as well as it's ability to spread through the blood (sepsis) causing failure of multiple organ systems. It is the most common cause of community acquired pneumonia that requires hospital care. The mortality for those requiring hospitalization is ten percent. Survivors recover rapidly after the person's immune system mounts a specific antibody response, and the patient's lung tissue recovers completely without residual damage or scarring.

 

The rapid clearing of the infection from the blood and lung tissue by the immune system stimulated interest in developing a vaccine. The vaccine contains parts of the bacteria cell wall that triggers an immune response, essentially pre training the body how to respond to an infection. The antibody side of our immune system takes seven to ten days to create a specific antibody response for a new infection. Only 24 hours is required to produce the same response with the second infection. The vaccine does not contain any live bacteria, so it cannot cause a real infection.

 

The effectiveness of the adult vaccine is still being questioned. It decreases the frequency of blood infections (sepsis) and decreases the number of cases of pneumonia in patients with advanced lung disease (COPD or emphysema). However, in normal adults, seven out of eight studies have not found a decrease in the frequency of community acquired pneumonia. Therefore, in adults the vaccine is recommended for patients over the age of 65 or for patients with medical problems or risk factors that make them more likely to contract the infection or have a poor outcome.

 

The childhood vaccine, however, is having a dramatic effect on Pneumococcal infections. Pneumonia, meningitis and ear infections have decreased. And the vaccine has had an indirect effect on adult infections with recent data finding a 50% decrease in pneumococcal meningitis in adults, presumably by decreasing exposure to sick children.

 

The development of more effective pneumococcal vaccines is timely, because this bacteria is developing resistance to common antibiotics previously used to treat the illness.

 

In summary. The childhood vaccine is essential for our child and our community. In adults it is reserved for those over 65 and anyone else with a significant medical problem. For more information see the CDC web site.