Title of the Article

Did You Know...? There is a New Vaccine Recommendation for Adults Age 65 and Older

November 17, 2014 | by Lynda Neuenschwander

"Adults 65 years of age or older are at increased risk for pneumococcal disease. PCV13 [Prevnar 13®] is recommended for all adults 65 years of age or older," as stated by the Centers for Disease Control and Prevention (CDC). [1]

If you are someone over the age of 65, or if you know someone who is over the age of 65, take note of this new recommendation and take action. People of the age of 50 and older have taken comfort in the already existing vaccinations to fight pneumonia for years, but as of August 13, 2014, an additional pneumococcal vaccine called Prevnar 13® (PCV13) is recommended for all seniors aged 65 and older.

This recommendation is made by the Advisory Committee on Immunization Practices. "ACIP is chartered as a federal advisory committee to provide expert external advice and guidance to the Director of the Centers for Disease Control and Prevention (CDC) on use of vaccines and related agents for the control of vaccine-preventable diseases in the civilian population of the United States."[2]

Here are a few highlights:

1. For adults aged 65 or older who have not had any previous pneumococcal vaccine or whose history of vaccinations is unknown, a dose of the vaccine called Prevnar 13® (13-valent conjugate) is recommended. Furthermore, physicians are advised to recommend a dose of Pneumovax (23-valent polysaccharide) for these patients six to 12 months after their PCV13 vaccination.

2. Another aspect of this new recommendation from the Advisory Committee states that if a patient 65 or older has received one or more doses of Pneumovax, but no previous Prevnar 13® vaccination, that patient should receive a dose of Prevnar 13® at least one year after administration of the most recent dose of Pneumovax. Prevnar 13® vaccination should be given six to 12 months before any additional dose of Pneumovax and at least five years after the most recent Pneumovax vaccination. Prevnar 13® is a product of Pfizer, Inc. and Pneumovax is a product of Merck.

Why the new recommendation?

Pfizer conducted a trial in the Netherlands among 85,000 participants aged 65 or older. Half of the group received the Prevnar 13® vaccination and the other half received a placebo. "In the vaccine group, about 45 percent fewer first episodes of vaccine-type community-acquired pneumonia were seen compared to the placebo group. Also, a 75 percent reduction in vaccine-type invasive pneumococcal disease was seen in the vaccine group compared with controls."[3] The staggering evidence from this study that is demonstrating how Prevnar 13® decreases risk of serious illness propelled the decision of the ACIP to recommend Prevnar 13® for all adults aged 65 and older.

How does this new recommendation fit into your Medicare coverage?

Well, in an ideal world, patients would receive both the Prevnar 13® and Pneumovax "vaccines separated by six months to a year to retain the initial vaccine's efficacy. But currently, Medicare only pays for one dose of pneumococcal vaccine for patients older than 65."[4]

Medicare will have to take into account the new recommendation and possibly allow for two pneumococcal vaccines for adults over the age of 65, but Medicare is not able to possibly take it into account until at least early 2016, according to a Medicare representative who had been present at the ACIP meeting. If someone over 65 is still carried under traditional insurance instead of being enrolled in Medicare, that second pneumococcal vaccine is typically more easily covered since traditional insurers are required to adhere to ACIP guidelines in a much shorter time frame than Medicare.

Elderly patients are about 3 times more likely over the age of 65 to acquire community-acquired pneumonia than those aged 50-64 and the prevalence rate aged 50-64 is 25 in 100,000. After the age of 65, that number jumps to 70 in 100,000. If you yourself have not already suffered from pneumonia at some point in your life, you probably know someone who has. It can be very serious, cause hospitalization, and possibly be fatal. Pneumococcal pneumonia is an illness caused by the type of bacteria called Streptococcus pneumonia and can be "carried in the throats of up to 70% of healthy people."[5]

"Most pneumococcal deaths in the U.S. are in adults. Yet about 70 million adults at highest risk remain unvaccinated, leaving them vulnerable. If you are at risk, vaccination is the safest, most effective way to protect yourself."[6] If you are unsure whether or not you have been vaccinated for pneumonia or are eligible to be vaccinated for pneumonia under this new recommendation for Prevnar 13®, seek advice from your healthcare professional, take heart that there is something more you can do to protect yourself, and take action.



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