Pneumococcal Vaccine and Patients with Pulmonary Diseases

Abstract

Chronic pulmonary diseases describe chronic diseases that affect the airways and lung parenchyma. Examples of common chronic pulmonary diseases include asthma, bronchiectasis, chronic obstructive lung disease, lung fibrosis, sarcoidosis, pulmonary hypertension and cor pulmonale. Pulmonary infection is considered a significant cause of mortality in patients with chronic pulmonary diseases. Streptococcus pneumoniae is the leading isolated bacteria from adult patients with community-acquired pneumonia, the most common pulmonary infection. Vaccination against S. pneumoniae can reduce the risk of mortality especially from more serious infections in both immunocompetent and immunocompromised patients. Patients with chronic pulmonary diseases who take steroids or immunomodulating therapy (e.g., methotrexate, anti-TNF inhibitors), having concurrent sickle cell disease or other hemoglobinopathies, primary immunodeficiency disorders, human immunodeficiency virus infection / acquired immunodeficiency syndrome (HIV/AIDS), nephrotic syndrome, and hematologic or solid malignancies should be vaccinated with both 13-valent pneumococcal conjugate vaccine (PCV13) and the pneumococcal polysaccharide vaccine 23-valent (PPSV23).

Use and Clinical Interpretation of Pneumococcal Antibody Measurements in the Evaluation of Humoral Immune Function

“…Pulmonary manifestations are the most common form of invasive pneumococcal disease, and this organism is responsible for roughly onethird of community-acquired pneumonia cases in the United States (1). Children, the elderly, and immunosuppressed patients are among the groups most susceptible to pneumococcal infection.…”

Pneumococcal Vaccination Among Adults With Work-related Asthma

“…8 Administration of the 13-valent pneumococcal conjugate vaccine is not indicated for adults with asthma aged <65 years unless the patient has iatrogenic immunodeficiency, such as through long-term systemic corticosteroid use, or has another immunosuppressing medical condition. 19–21 Among adults in whom 13-valent pneumococcal conjugate vaccine is indicated, a single dose of 13-valent pneumococcal conjugate vaccine should be administered prior to or at least a year after receiving the 23-valent pneumococcal polysaccharide vaccine. Adults should not receive a pneumococcal vaccine if a severe allergic reaction occurred after a previous dose or to any component of the vaccine; however, an event such as this is exceedingly rare.…”

Paediatric and adult bronchiectasis: Vaccination in prevention and management

“…Preventing severe bacterial pneumonia in children may reduce the risk of bronchiectasis in children and adults, while in those with established bronchiectasis preventing lower airway infection and pneumonia may minimise further lung damage and premature mortality . A post hoc analysis of the efficacy of the 13‐valent PCV in over 40 000 adults in the Netherlands at high risk of community‐acquired pneumonia (CAP), including those with chronic lung disease, demonstrated a vaccine efficacy of 40.3% (95.2% CI: 11.4%–60.2%) against the first episode of vaccine‐type CAP with an average follow‐up duration of 3.95 years.…”