Expert Q&A

Pneumococcal disease is a serious and deadly infection, but most people know very little about it. We’ve assembled a panel of experts to answer common questions about pneumococcal disease. Select a question below to learn more.

What causes pneumococcal disease?

Answered by:

Richard Kent Zimmerman, MD, MPH, MA University of Pittsburgh

“The potential suffering from pneumococcal disease includes limb loss and substantial trouble breathing whereas the vaccine side effects are typically minor local reactions, like soreness at the injection site.”

Answer:

The disease is caused by the “pneumococcus,” a type of bacteria that causes a variety of infections at various sites in the body including the ears, sinuses, lungs and blood stream.

How many people get it?

Answered by:

Thomas M. File Jr., MD, MS President, NFID

“The risk of mortality of a patient admitted to the ICU with pneumococcal pneumonia is greater than that of a typical patient admitted to the coronary care unit with a heart attack!”

Answer:

Literally millions of Americans are infected with pneumococcus annually. We actually don’t know the total number since it is so large and includes infections that are relatively mild (such as sinus and ear infections) as well as severe ones like pneumonia, blood infection and meningitis, where the death rate can be more than 30 percent.

Can it be cured?

Answered by:

Thomas M. File Jr., MD, MS President, NFID

“The risk of mortality of a patient admitted to the ICU with pneumococcal pneumonia is greater than that of a typical patient admitted to the coronary care unit with a heart attack!”

Answer:

Yes, most cases can be cured with appropriate antibiotics if they’re given in a timely manner. However, it is very important to know that even with appropriate antibiotic therapy, the mortality rate can be high in patients who are elderly or have underlying medical conditions such as diabetes, heart disease or chronic lung disease. This is why it is so much better to prevent the infection if possible rather than waiting to treat it.

What can happen if I get it?

Answered by:

Mark Metersky, MD University of Connecticut Health Center

“I'm committed to helping reduce pneumococcal disease among adults in the U.S. because over the years, I have seen too many lives cut short by pneumococcal disease.”

Answer:

Pneumococcus can cause serious infections. The most common is “pneumococcal” pneumonia, which is the most common type of severe pneumonia. Another serious manifestation of pneumococcal disease is meningitis, an infection of the lining of the brain. More common types of pneumococcal infection include sinusitis and bronchitis.

Can I die from pneumococcal disease?

Answered by:

Mark Metersky, MD University of Connecticut Health Center

“I'm committed to helping reduce pneumococcal disease among adults in the U.S. because over the years, I have seen too many lives cut short by pneumococcal disease.”

Answer:

Yes, pneumococcal disease causes thousands of deaths in the United States each year.

How do people catch pneumococcal disease? Are there places or people to avoid?

Answered by:

Robert H. Hopkins Jr., MD University of Arkansas

“Pneumococcal infections have been a burden to adults and children for many generations, causing hospitalization and or death in tens of thousands in this country every year. We need to use the tools we have available — like vaccination, increased hand-washing and only using antibiotics when they’re appropriate — to keep our society healthier.”

Answer:

Pneumococcal disease is caused by the “pneumococcus,” a germ that is present in the airways of many people. It is spread by coughs, sneezes and other respiratory secretions. Pneumococcal bacteria may also live for a short time on surfaces. These bacteria, along with many others, are particularly common in areas where people — particularly small children — are in close quarters with one another. Daycare centers, schools and long-term care facilities are places where there would be a higher risk of getting pneumococcal disease.

Can I give it to my grandparents or the kids in my family?

Answered by:

Carol J. Baker, MD Baylor College of Medicine

“Pneumococcal disease among adults in the U.S. is the number one cause of serious pneumonia and has been associated in adults 65 years or age and older with an increased risk for heart attacks.”

Answer:

Yes, but this can be prevented by pneumococcal vaccination of infants and children according to the recommended schedule. The pneumococcus lives in the nose and throat, especially in infants and young children who have not been vaccinated. Using the routinely recommended pneumococcal vaccine in infants and children (which is different than the vaccine used in adults) prevents the bacteria from being carried in their noses and throats so it can’t be passed on to others. This bacterium is uncommonly carried by older children and adults so spread typically can be prevented by cough hygiene and hand washing.

What are the symptoms?

Answered by:

Richard Kent Zimmerman, MD, MPH, MA University of Pittsburgh

“The potential suffering from pneumococcal disease includes limb loss and substantial trouble breathing whereas the vaccine side effects are typically minor local reactions, like soreness at the injection site.”

Answer:

The symptoms of pneumococcal disease vary by which parts of the body are infected. If the lungs are infected, fever, chills, sweats, shortness of breath, coughing and chest pain may occur.

Who can get pneumococcal disease?

Answered by:

Robert H. Hopkins Jr., MD University of Arkansas

“Pneumococcal infections have been a burden to adults and children for many generations, causing hospitalization and or death in tens of thousands in this country every year. We need to use the tools we have available — like vaccination, increased hand-washing and only using antibiotics when they’re appropriate — to keep our society healthier.”

Answer:

Anyone can get a pneumococcal infection; but severe infections are more likely in very young children, older adults and persons who have chronic health conditions.

Are there any racial or ethnic groups at particular risk for pneumococcal disease?

Answered by:

Richard Kent Zimmerman, MD, MPH, MA University of Pittsburgh

“The potential suffering from pneumococcal disease includes limb loss and substantial trouble breathing whereas the vaccine side effects are typically minor local reactions, like soreness at the injection site.”

Answer:

Yes. Racial and ethnic groups at increased risk include Native Alaskans, certain Native Americans and African Americans.

How can I avoid getting pneumococcal disease?

Answered by:

Kristin L. Nichol, MD, MPH, MBA University of Minnesota

“Pneumococcal disease can cause serious illness and even death. We have a safe vaccine that works. If you are in one of the high priority target groups, then I strongly recommend vaccination for you.”

Answer:

Pneumococcal diseases can cause serious illness and even death among adults. Especially serious forms of the disease are known as invasive pneumococcal disease and include bloodstream infections (bacteremia) and infections of the lining of the brain (meningitis). The best way to prevent these serious forms of pneumococcal disease is through vaccination.

Does the vaccine work?

Answered by:

Kristin L. Nichol, MD, MPH, MBA University of Minnesota

“Pneumococcal disease can cause serious illness and even death. We have a safe vaccine that works. If you are in one of the high priority target groups, then I strongly recommend vaccination for you.”

Answer:

The pneumococcal polysaccharide vaccine is used in adults. It protects against 23 different types of pneumococcal organisms, and it is indeed safe and effective. Studies suggest vaccination will prevent between 50 to 80 percent of cases of so-called invasive pneumococcal disease. So, yes, the vaccine does work.

Aren’t vaccines just for kids?

Answered by:

Carol J. Baker, MD Baylor College of Medicine

“Pneumococcal disease among adults in the U.S. is the number one cause of serious pneumonia and has been associated in adults 65 years or age and older with an increased risk for heart attacks.”

Answer:

Vaccines for infants and children are important and sometimes life-saving. But vaccine-preventable infections affect even healthy adolescents and adults. Prime examples are influenza with its annual epidemics; pertussis or whooping cough, which is occurring in epidemics in California and several other states this year; and pneumococcal disease, which most often causes moderate to severe pneumonia. These three infections not only are capable of causing infections that can be spread to more vulnerable people like very young infants who may be hospitalized or die (influenza and whooping cough), but these infections have also been associated with heart attacks (influenza and pneumococcus) in adults age 65 years and older. Vaccines are for everyone.

Who should be vaccinated against pneumococcal disease?

Answered by:

William Schaffner, MD Past-President, NFID

“If I had one thing to say to a patient about the seriousness of pneumococcal disease and the importance of prevention, it would be... just do it. Pneumonia can kill — vaccination is both effective and safe.”

Answer:

Everyone 65 and older should be vaccinated against pneumococcal disease. Folks who are younger than age 65 should get vaccinated if they fall into one of the groups with increased risk of serious pneumococcal infection: chronic lung disease (including asthma), heart disease, diabetes, chronic liver disease, alcoholism, sickle cell disease, persons who have lost their spleen, any immunocompromising condition, chronic kidney disease, or if a patient has a cochlear implant or a cerebrospinal fluid leak. In addition, everyone who smokes cigarettes should receive pneumococcal vaccination.

How often do I need to get vaccinated?

Answered by:

William Schaffner, MD Past-President, NFID

“If I had one thing to say to a patient about the seriousness of pneumococcal disease and the importance of prevention, it would be... just do it. Pneumonia can kill — vaccination is both effective and safe.”

Answer:

If you are older than age 65, you need just one vaccination. A second dose is recommended in certain circumstances that you should talk to your doctor about. For example, individuals age 19 and older who have chronic kidney failure, have lost their spleen, or have immunocompromising conditions need two pneumococcal vaccines followed by another dose after five years.

I already got the vaccine. Do I need another?

Answered by:

William Schaffner, MD Past-President, NFID

“If I had one thing to say to a patient about the seriousness of pneumococcal disease and the importance of prevention, it would be... just do it. Pneumonia can kill — vaccination is both effective and safe.”

Answer:

If you got the vaccine when you were 65 or older, you only need that one vaccination. A second dose is recommended in certain circumstances that you should talk to your doctor about. For example, individuals age 19 and older who have chronic kidney failure, have lost their spleen, or have immunocompromising conditions need two pneumococcal vaccines followed by another dose after five years.

How do I know it’s safe? Is it possible to get the disease from the vaccine?

Answered by:

Kristin L. Nichol, MD, MPH, MBA University of Minnesota

“Pneumococcal disease can cause serious illness and even death. We have a safe vaccine that works. If you are in one of the high priority target groups, then I strongly recommend vaccination for you.”

Answer:

Vaccines are tested very thoroughly in clinical trials before they are approved. The current pneumococcal polysaccharide vaccine was approved nearly 30 years ago and has an excellent safety record based on pre-licensure studies as well as studies conducted after licensure. In addition, the national vaccine safety surveillance program sponsored by the CDC and FDA (VAERS) has demonstrated the safety of this vaccine over many years and after tens of millions of doses given in the US alone.

I was vaccinated for pneumococcal disease, but I still got pneumonia. Does that mean
the vaccine didn’t work?

Answered by:

Kristin L. Nichol, MD, MPH, MBA University of Minnesota

“Pneumococcal disease can cause serious illness and even death. We have a safe vaccine that works. If you are in one of the high priority target groups, then I strongly recommend vaccination for you.”

Answer:

No, it doesn’t. Pneumonia can be caused by many other types of organisms besides the pneumococcal organism, and the vaccine doesn’t work against those other types of bacteria. Secondly, the pneumococcal polysaccharide vaccine protects against 23 types of pneumococcal organisms that are responsible for most infections, but there are other types not covered by the vaccine. Finally, this vaccine is most effective — not so much at preventing pneumonia caused by the pneumococcal organisms — but at preventing the especially serious complications of pneumococcal disease known as invasive pneumococcal disease that might accompany pneumonia.

My doctor said I should also get an annual flu shot. Why do I need both vaccines?

Answered by:

William Schaffner, MD Past-President, NFID

“If I had one thing to say to a patient about the seriousness of pneumococcal disease and the importance of prevention, it would be... just do it. Pneumonia can kill — vaccination is both effective and safe.”

Answer:

Influenza and pneumococcal vaccines protect against two different diseases, both of which can cause serious, life-threatening illnesses and both diseases involve the lungs.

Influenza is the winter virus that can affect even healthy people, causing an illness that is so severe it can result in hospitalization.

The pneumococcus is a germ that can cause pneumonia and other infections such as in the bloodstream (bacteremia) and lining of the brain (meningitis). It is especially good at causing pneumonia as a complication of influenza infection. So you can understand why it is so important to be vaccinated to get protection against both influenza and the pneumococcus. Both vaccines are very safe.

How much does the vaccine cost?

Answered by:

Kristin L. Nichol, MD, MPH, MBA University of Minnesota

“Pneumococcal disease can cause serious illness and even death. We have a safe vaccine that works. If you are in one of the high priority target groups, then I strongly recommend vaccination for you.”

Answer:

The vaccine is free for people on Medicare. For others, their cost will depend on insurance coverage and doctors’ fees, which vary. Most insurance plans provide at least some reimbursement for vaccines if they are recommended for you.

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Pneumococcal Disease