Pneumonia vaccinations in Australia

[AussieNeil]

I've written this for our Australian members that wish to reduce their likelihood of contracting pneumonia by availing themselves of free/reduced cost pneumonia public vaccinations, following a query by 'Mike113', who was told by his doctor that the "Pneumovax 23 vaccination was sufficient".

Per immunise.health.gov.au/inte...

Australians with CLL qualify under Category A - immunocompromising conditions, including: haematological and other malignancies for up to 3 Pneumovax 23 vaccinations in their lifetime, with a minimum of 5 years between vaccinations.

My interpretation of that webpage is that you aren't precluded from having the two different vaccinations (with a gap of 2 months recommended), so you might be able to convince your doctor to give you the two vaccinations two months apart if you are in a situation where you are at a greater risk of being exposed to the pathogens responsible. The dilemma the authorities have is that there's evidence that people respond better to Prevnar 13, but it doesn't give as wide a coverage of pneumonia causing pathogens as the Pneumovax 23.

The relevant sections are section 4.13.4 where it says: "13vPCV has also been registered since October 2011 for use in adults aged ≥50 years, based on immunogenicity data showing equivalent or better antibody responses than those provided by 23vPPV for the shared vaccine serotypes. There are currently no data on clinical outcomes for 13vPCV, but a study examining its efficacy against pneumonia in adults is underway.41 In the absence of evidence of superior effectiveness against IPD or non-IPD pneumonia, the relative benefit of 13vPCV over 23vPPV for adults is uncertain, since the serotype coverage of 13vPCV is more limited. It is also uncertain whether the level of reduction in IPD due to the additional serotypes contained in 13vPCV among adults (herd immunity effect) will be similar to that seen following widespread use of 7vPCV in children."

and Adults aged >=18 yrs under 4.13.7 Recommendations: "Although 13vPCV is registered for use in adults aged ≥50 years, there is currently insufficient evidence to recommend its use in preference to 23vPPV at the individual or population level for persons aged ≥18 years who do not have a condition(s) associated with an increased risk of IPD (see 4.13.4 Vaccines above). Updated recommendations on the use of 13vPCV in adults without an increased risk of IPD will be made when more data are available (see Immunise Australia website)."

The interpreted version below might be easier to read for a high level overview about the causes , (and it totally ignores the situations in which vaccinations with both may be advisable) but your doctor should go by the official immunise.health.gov.au website :

nps.org.au/medicines/immune...

I'll be interested in feedback from those that try for both the Prevnar 13 and Pneumovax 23 vaccination.

Neil

Photo: Late afternoon sun on the stubble. I love the way that late afternoon light softens our country landscapes.

[shezsam]

Hi Neil,

Your information is correct, I work in a medical centre & Prevnar 13 is mainly used for children & is given 2months old, 4 months old or 6 months old. We use the Pneumovax 23 for adults & it is given every 5 years & you can have up to 3 shots.

Hope that has been a bit of help & makes it easier for people to understand.

Scheryl

[AussieNeil Administrator in reply to shezsam]

Thanks Scheryl. It is obviously going to be difficult for the health authorities to write an all encompassing explanatory web page that is also easy to read for every instance where the vaccines may be given. It's also interesting to observe that the Australian authorities are leaving the way open to possibly approve administration of Prevnar 13 to some adult categories in the future.

[Mike113]

Hi

Just have organized the vaccines. Prevnar 13 first at our own expense. This will be followed by pneomovax 23 after the required interval on PBS. I told the GP that prevnar 13 has shown to give a better antibody response and that the GP had looked into it and said this was his findings also. So off we go to have a needle tomorrow. Keep well everyone.

[AussieNeil Administrator in reply to Mike113]

Well done! You've also earned some kudos with your doctor that will hopefully put you in good stead in the future.

Neil