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Recommended Vaccines

Take Your Best Shot at Prevention by Staying Up-to-Date on Recommended Vaccines

If you have chronic kidney disease (CKD), there are important vaccines you should know about to help protect your health. One vaccine specifically recommended for adults with CKD helps prevent pneumococcal disease (pronounced noo-muh-kok-ul).

Most people hear “pneumo” and think about “pneumonia,” but that’s just part of the story. A bacterial infection, pneumococcal disease can cause several serious and potentially life-threatening illnesses, including pneumonia, meningitis, and blood poisoning (sepsis).

The Centers for Disease Control and Prevention (CDC) recommends pneumococcal vaccination for everyone at age 65. Adults of any age with certain health conditions, including those in all stages of CKD, dialysis patients, and kidney transplant recipients should also receive the vaccine.1 Yet, the CDC recently reported only about 20 percent of adults ages 19-64 who are recommended for pneumococcal vaccination have received it and less than 60 percent of adults 65 and older have been vaccinated, leaving them needlessly at risk for serious illness.

Following are answers to common questions about pneumococcal disease that help explain why its prevention is important for people with CKD.

What causes pneumococcal disease?

Pneumococcal disease is caused by the “pneumococcus,” a type of bacteria that can infect various sites in the body including the ears, sinuses, lungs, and blood stream. Pneumococcal infections can strike quickly and make someone very sick within hours.

Why does having CKD increase a person’s risk for pneumococcal disease?

One reason people with CKD are at greater risk for pneumococcal disease is because kidney disease can weaken the immune system and make the body more susceptible to infection.3 This is true even if your kidney disease is well controlled with medication or other treatment. Doctors and researchers have found that infections in people with CKD, such as those caused by pneumococcal disease, are worse and can be more serious than in people who don’t have CKD.4

How does someone get pneumococcal disease?

Pneumococcal bacteria live in the throat and spread through coughing, sneezing, or through direct contact such as kissing. Not everyone who carries the bacteria gets sick from it, so it’s possible to “catch” pneumococcal disease from someone who doesn’t appear to be sick.

What are the symptoms of pneumococcal disease?

Symptoms can vary from person to person and can appear very suddenly and without warning. Depending on whether the infection causes pneumonia, sepsis, or meningitis, people may have some combination of the following:

  • Abrupt onset of fever
  • Shaking/chills
  • Cough
  • Shortness of breath
  • Chest pain
  • Stiff neck
  • Disorientation

What’s the difference between pneumonia and pneumococcal disease?

You may know someone who got the “pneumonia” vaccine but still got pneumonia. There are several reasons this can happen. Any number of bacteria, viruses, and even fungi can infect the lungs and cause pneumonia. Pneumococcal vaccination protects against pneumococcal bacteria only. Although vaccination provides the best available protection against pneumococcal infection, it doesn’t eliminate your risk. It’s still important to get vaccinated, though because vaccination can reduce the severity of the illness.

When and where can I get pneumococcal vaccination?

Pneumococcal vaccines are available year-round at most primary care offices as well as many pharmacies and public health departments. Medicare and most private insurers cover the cost of vaccination for those who need it.

How many doses of pneumococcal vaccination do I need?

There are two types of pneumococcal vaccines available for adults: a pneumococcal polysaccharide vaccine (PPSV23) and a pneumococcal conjugate vaccine (PCV13).1 Most adults only need to be vaccinated one time, but those with all stages of CKD, dialysis-treated patients, and kidney transplant recipients, need to receive both types of pneumococcal vaccine initially, followed by revaccination in 5 years. Your doctor or other health care professional will be able to advise you about your specific circumstances.

Don’t stop at pneumococcal prevention; there are many other vaccines that are important for adults with CKD. Vaccines are safe, effective and readily available, making them an easy tool for disease prevention. All adults should receive an annual influenza (flu) vaccination. Pneumococcal infection is a common complication of the flu, making prevention of both an important part of staying healthy for adults with CKD.

There are also vaccines recommended based on other underlying health conditions. For example, adults with diabetes through age 60 should be vaccinated against hepatitis B because their risk of acute hepatitis B infection is twice as high compared to adults without diabetes. Hepatitis attacks the liver and in the early, acute stages it can cause months of symptoms, including loss of appetite, tiredness, nausea, vomiting, joint pain, and jaundice. In some people, hepatitis B can become chronic, leading to liver cirrhosis, liver cancer, and liver failure even decades after the original infection.

Tdap, or the whooping cough booster, is another important vaccination for all adults. It is a combination vaccine that helps prevent whooping cough (or pertussis), tetanus, and diphtheria.8 Rates of whooping cough have been increasing in the U.S., and adults can give this serious infection to infants, who are at a greatly increased risk of serious complications including death.

Don’t hesitate to take your best shot at protection. Ask your health care provider or pharmacist today about pneumococcal and other recommended adult vaccines. For more information, please visit: http://www.adultvaccination.org from the National Foundation for Infectious Diseases.

Dr. William Schaffner is the immediate past-president of the National Foundation for Infectious Diseases and professor of preventive medicine and medicine (infectious diseases) at the Vanderbilt University School of Medicine.