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Diana Castaneda
Latin Agency for Medicine and Public Health News
An important part that the CDC and the Vaccination Committee recommend is that clinical decision making be shared with patients, which means that vaccine determination must be joint between the healthcare provider and the patient.
This was stated by the pulmonologist, Luis García Barreto, for the Journal of Medicine and Public Health (MSP), where he also acknowledged that “This decision must be made by both sides, with the aim of educating the patient to decide on a correct vaccine, appropriate for their medical condition and age.”
García assures that this is important as it is necessary to take into account what the patient’s comorbidities are and which vaccine he needs to have proper and complete short and long-term immunological protection against pneumococcal infection.
On the other hand, the CDC guidelines clarify that, after the shared clinical decision has been made, the healthcare specialist must offer PREVNAR13 as the first alternative to the vaccine, followed by pneumovax 23.
Impact of adequate vaccination
Having the correct vaccination order ensures an adequate long-term immune response, which protects patients from pneumonia.
“Applying PREVNAR13 first has been shown to increase protection against pneumococcus by creating a long-term memory of these immune cells,” warns the doctor.
When we talk about pneumococcal disease or condition we recognize the non-invasive part, which is the most common and in which the patient has developed pneumonia without certain complications that lead him to intensive care, artificial respiration or that there is still time to cure like walking pneumonia.
Regarding invasive pneumonia, Dr. García Barreto explains that this is more complicated and in which the patient requires hospitalization and, in addition, the organism can pass into the blood and remain in a state of sepsis.
“In fact, pneumococcus continues to be the most common bacterium to produce sepsis, leading the patient to a state of respiratory intubation or to a hospitalization in intensive care. Even these people who develop sepsis, the bacteria travel through the bloodstream producing meningitis in the worst cases, having very high mortality, “he stressed.
Therefore, the pulmonologist insists on the importance of prevention, to avoid a complication of invasive pneumonia which, although not as common, is the most serious.
Recommendations in immunocompetent patients over the age of 65
In the elderly, people are more vulnerable to contracting viral and bacterial infections or diseases. Hence the importance of prevention through immunization processes.
Pneumococcal bacteria occur in 25% of cases and are responsible for 50,000 cases per year in the United States, with a mortality of 5 to 7%. In the elderly this is completely lethal in 60%.
The CDC recommends that after a shared clinical decision has been made, PREVNAR 13 and pneumovax 23 are applied after one year and, then, patients are vaccinated for life.
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