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Ask The Experts: Why is the pneumococcal pneumonia vaccine key to maintaining good health for seniors?

With seniors more vulnerable to pneumococcal pneumonia due to natural decline in immune systems, Dr Edwin Chng from Parkway Shenton explains why it is one of the recommended vaccines

The elderly are at a higher risk for hospitalisation for pneumococcal pneumonia. In severe cases, it can even be life-threatening. PHOTO: PFIZER

Q. My 65-year-old father just received his Covid-19 booster shot. However, during a medical checkup, the doctor recommended that he be vaccinated against pneumococcal pneumonia as well due to his age. What is pneumococcal pneumonia and why should he get the vaccine?

Pneumococcal pneumonia is a lung infection caused by a bacteria called Streptococcus pneumoniae.

Besides the lungs, the bacteria can also affect other parts of the body such as the ears, sinuses, brain and spinal cord, and blood. In severe cases, pneumococcal disease may cause hearing loss, brain damage, and even death.

Hence, it is important for those with risk factors for pneumococcal disease or who might suffer more severe complications be vaccinated against it.

Q. Why is it especially important now, during the Covid-19 pandemic, for the elderly to be vaccinated against pneumococcal pneumonia?

Given that the Covid-19 pandemic is expected to persist over the next few years, there is likely to be an increased risk of people being infected with both Covid-19 and pneumococcal pneumonia.

Such cases have been reported in several countries and may make diagnosis and treatment of Covid-19 or pneumococcal pneumonia more challenging.

Age is also a risk factor for contracting pneumococcal pneumonia as the immune system naturally weakens as we get older. Studies show that when compared with younger adults aged between 18 to 49, adults aged 65 years and above are nearly six times at greater risk for pneumococcal pneumonia.

The elderly are also more susceptible to severe infections from the disease, such as bacteraemia (bacteria in the blood) and meningitis (inflammation of the brain and spinal cord) with a high death rate of up to 10 to 36 per cent.

Q. My father leads a relatively healthy and active lifestyle and has only mild diabetes. Are there increased risks for older individuals with chronic conditions?

Studies show that patients above 65 years old with diabetes and chronic heart disease have an increased risk of up to 2.8 times and 3.8 times respectively as compared to their peers.

For those below 65 years old with chronic illnesses such as asthma and diabetes, they are considered at high-risk for pneumococcal pneumonia as well. They should get the vaccine even if they are below 65 years old.

Q. What are the symptoms of pneumococcal pneumonia?

The common symptoms are high fever, chills, sweating, fatigue, coughing, difficulty breathing, shortness of breath and chest pain.

Q. My father occasionally takes care of my young toddler. Is there a possibility that the pneumococcal bacteria may be passed in between them?

The bacteria is spread through direct contact, respiratory droplets from coughing or sneezing, and articles contaminated with these infected droplets.

Other than the elderly or those with chronic medical conditions, children below five years old, and especially those below two, are at increased risk for the disease. This is why pneumococcal vaccination is a routine part of infant and childhood immunisation schedules worldwide, including in Singapore.

The pneumococcal bacteria can be passed between individuals. Besides the elderly, young children below the age of five are also at a higher risk for pneumococcal pneumonia. PHOTO: SHUTTERSTOCK

Q. Is it safe for my father to receive his pneumococcal vaccination so soon after his Covid-19 booster shot?

Those who have received a Covid-19 vaccine are encouraged to defer other non-Covid-19 vaccinations by at least two weeks.

However, it is still acceptable to take another vaccine, such as the pneumococcal vaccine, earlier if he or she wishes to, according to the US Centers for Disease Control and Prevention (CDC).

Q. We might be looking to take a family vacation in December under the Vaccinated Travel Lane (VTL) scheme. Should this influence my father's decision to get vaccinated against pneumococcal pneumonia?

As pneumococcal pneumonia is the most common cause of community-acquired pneumonia worldwide, those at increased risk are advised to take the vaccine before travelling.

This is especially important for travel to developing countries, where the disease incidence is higher than in industrialised countries.

Q. What are the priority vaccine(s) one should note and take?

The priority vaccines are the COVID-19 vaccine, flu vaccine and pneumococcal vaccine.

As other travel vaccines are also important, it is important to discuss with a doctor prior to travel. To determine which vaccines are relevant and useful, the travel destination and risk factors of the traveller, such as age and medical history, are important considerations.

Q. Are there any individuals who may be ineligible for the vaccine?

Only those who have a history of severe allergic reactions (eg. breathing difficulties, loss of consciousness) to the pneumococcal vaccine or any of its components are not suitable for the vaccine.

Women who are pregnant or breastfeeding are also advised to defer the vaccine.

Q. How long does the pneumococcal pneumonia vaccination last? Are any booster shots required?

There are two types of pneumococcal vaccines - the pneumococcal conjugate vaccine (PCV13) and the pneumococcal polysaccharide vaccine (PPSV23).

PCV13 protects against 13 pneumococcal bacteria strains that most commonly cause pneumococcal disease, while PPSV23 protects against 23 strains.

In adults, those above 65 years old should receive one dose each of PCV13 and PPSV23. Other adults with chronic illnesses and who are immunocompromised should consult a doctor on which vaccine to take.

All infants should be given two doses of PCV13 with a booster at 12 months, as part of the Singapore National Childhood Immunisation Schedule.

Q. Where can my father get vaccinated against pneumococcal pneumonia?

He can visit a polyclinic or GP to get the vaccine. Singaporeans above 65 years old can opt to use their Medisave to pay for the vaccine at Medisave-accredited healthcare institutions, such as polyclinics and CHAS GP clinics.

All adult Singaporeans will also receive up to 75 per cent subsidy for all vaccines under the National Adult Immunisation Schedule. Pioneer Generation and Merdeka Generation seniors will also receive an additional 50% and 25% subsidy respectively.

Younger adults can also use their Medisave if they have certain chronic illnesses (such as diabetes, chronic lung, heart, kidney or liver disease) or are immunocompromised.

To find out more about the pneumococcal pneumonia vaccine, consult your doctor or visit knowpneumonia.sg.

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