Do I Need the Pneumonia Shot if I Have Asthma?

pneumonia vaccination
Pneumonia Shot. © David McNew/ Getty Images

Question: Do I Need the Pneumonia Shot if I Have Asthma?

Getting shots is no fun and you have had your flu shot, but should you get the pneumonia shot or pneumococcal vaccine as well?

Answer:

Asthma is a risk factor for the invasive pneumococcal disease -- what the pneumonia shot protects against. And while it is not as common as the flu, which you should protect yourself against annually with a flu shot, invasive pneumococcal disease does have serious potential complications.

So, yes, it makes sense to prevent the disease altogether by getting the pneumonia shot, if it's recommended for you.

Who Should Get the Pneumonia Shot: The CDC's New Recommendations

In January 2009, the Centers for Disease Control updated its recommendation for the pneumococcal vaccine. The recommendation states that you should receive the pneumococcal vaccine if you are:

  • Over the age of 65
  • Between the ages of 18 and 65 and have a chronic heart or lung condition, such as asthma
  • Immunocompromised or have a weakened immune system

However, in 2013 it got a little more complicated. For asthma, it is still recommended that patients between the ages of 19 and 64 receive the pneumococcal vaccine that has been given for some time as outlined below. In 2013 it became apparent that certain patients benefit from an additional pneumococcal vaccine. Generally, the additional vaccine is recommended if you are over age 65 or have any of the following conditions or problems such as:

  • Cerebrospinal fluid leak
  • Cochlear implant
  • You do not have a functioning spleen (organ that helps fight off infection and supports the immune system)
  • Congenital or acquired immunodeficiency (you do not have certain cells that fight off infection)
  • HIV infection
  • Chronic renal failure (a problem with kidneys that leads to problems getting rid of waste products)
  • Nephrotic syndrome (another specific kidney problem more common in pediatric patients)
  • Leukemia and lymphoma (cancers of the blood stream)
  • Hodgkin disease (another cancer)
  • Multiple myeloma
  • Other cancers excluding skin
  • IYour immune system is suppressed due to medications like steroids
  • Organ transplant

Asthma is not one of the conditions that require the additional vaccine. However, if you turn 65 or have one of these mentioned conditions you should discuss it with your doctor.

How Come I've Never Needed the Pneumonia Shot Before?

A 2008 Cochrane Review stated there was limited information to support vaccination of asthmatics with the pneumococcal vaccine based on available evidence from randomized controlled trials. However, the CDC Advisory Committee on Immunization Practices (ACIP) subsequently voted in October 2008 to recommend the vaccination for all patients with asthma over the age of 18.

Why the sudden change? This new recommendation was partially based on new research reports indicating that asthmatics were at increased risk of pneumococcal infections.

A 2008 report cited an increased risk of invasive pneumococcal disease among patients with asthma. Patients with asthma were more likely to develop the following problems compared to patients without asthma:

  • Sepsis and bacteremia (significant infections in the blood stream)
  • Meningitis (an infection of the tissue surrounding your brain)
  • Pneumonia (a lung infection)
  • Osteomyelitis (a bone infection)

In a similar study, patients with asthma who were enrolled in Tennessee's Medicaid program TennCare were more than 2 times as likely to develop the invasive pneumococcal disease compared to non-asthmatics.

Your Next Steps

These findings generally support the idea that asthma is a risk factor for the invasive pneumococcal disease. While not as common as the flu, high blood pressure, or diabetes, invasive pneumococcal disease has serious potential complications.

Discuss getting the vaccine with your health care provider.

Sources:

T.R. Talbot, T.V. Hartert, E. Mitchel, N.B. Halasa, P.G. Arbogast and K.A. Poehling et al. Asthma as a risk factor for the invasive pneumococcal disease. NEJM 2005 352: 2082–2090.

T.V. Hartert. Are persons with asthma at increased risk of pneumococcal infections, and can we prevent them? J Allergy Clin Immunol 122 (2008) 724–725

Y.J. Juhn, H. Kita, B.P. Yawn, T.G. Boyce, K.H. Yoo and M.E. McGree et al. Increased risk of serious pneumococcal disease in patients with asthma. J Allergy Clin Immunol 122 (2008) 719–723.

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