The vaccines (both inactivated and live attenuated type) of influenza (including swine flu) generally have to be given every year to get full protection. The vaccines are not recommended to all the individuals and only selected individuals should be vaccinated yearly. If you fall in the group mentioned below, you should get flu vaccine shot.
The annual vaccine of influenza is recommended among the following individuals:
- Children of 6 months up to 5 years of age.
- Individuals of more than 50 years of age (but live attenuated vaccine is recommended in persons of 5 years to 50 years of age only).
- Individuals of 6 months to 18 years of age who are receiving long term aspirin (for any cause) as they are at high risk of developing Reye’s syndrome if they contract influenza.
- Health care workers (doctors, nurses, paramedical staffs and other health care related) who are at high risk of contracting swine flu due to professional contacts. Read more…
The pneumococcal vaccine which is used in children is protein-conjugated with polysaccharides. Pneumococcal capsular polysaccharide vaccine is not effective in children below 2 years of age as the immune system of children below 2 years do not respond to polysaccharide antigens properly. If capsular polysaccharide is conjugated with a protein the immune system responds well to protein-conjugated polysaccharides (antigen).
The protein-conjugated polysaccharides vaccine is recommended among infants and children. The introduction of protein-conjugated polysaccharides vaccine in the year 2000 has caused dramatic reduction of pneumococcal infection among children and infants in many countries. The vaccine is made of 7 serotypes of Streptococcus pneumoniae which cause infection among children commonly.
In one study the protein-conjugated polysaccharides vaccine was found to reduce pneumococcal infection (meningitis) by 98% and otitis media (infection of middle ear) by more then 65%, by the seven serotypes, used in the vaccine.
The incidence of pneumococcal infection among unvaccinated children and adults also declined due the effect of “herd immunity”, which may be due to effects of the protein-conjugate polysaccharides vaccine on nasopharyngeal carriage of vaccine serotypes. Herd immunity is the immunity of a community that develops due to widespread use of vaccines, even among non immunized individuals.
A disadvantage of widespread use of protein-conjugated polysaccharides vaccine is, increased incidence of infection by the serotypes of Streptococcus pneumoniae that are not included in the vaccine and these serotypes are becoming increasingly resistant to antibiotics. But in general there is dramatic decline in the incidence of infection by Streptococcus pneumoniae.
There are two types of vaccines available for prevention of pneumococcal pneumonia. The first is pneumococcal capsular polysaccharide vaccine, used for vaccination of adults and the second pneumococcal vaccine is protein conjugated pneumococcal vaccine, used for immunizing children.
Pneumococcal capsular polysaccharide vaccine is in use since 1980s and is made from capsular polysaccharides of 23 serotypes of Streptococcus pneumoniae which are most prevalent in any community. The vaccine found to be effective in several studies, although the effect decreases with age of the immunized individual and also time from vaccination (the effectiveness of vaccine decreases slowly 5 years after administering the vaccine).
Who should get vaccinated with pneumococcal capsular polysaccharide vaccine?
The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention recommends the following individuals to be vaccinated with pneumococcal capsular polysaccharide vaccine:
- All individuals aged more then 2 years (two) who are at risk of pneumococcal infection or at risk of developing complication.
- Individuals who underwent spleen removal or have anatomical abnormality in spleen.
- Persons of more then 65 years of age.
- Immunocompromised persons such as multiple myeloma, lymphoma, Hodgkin’s disease, HIV infection, undergone any organ transplantation, individuals who use glucocorticoid regularly etc.
- Individuals with diabetes, chronic lung disease, cardiovascular disease, CSF leakage, cirrhosis, chronic alcoholics, persons with chronic renal insufficiency etc.
- Health care professionals.
- Native Americans and Native Alaskans in USA, as they are at increased risk of developing pneumococcal pneumonia due to genetic predisposition.
Unfortunately the pneumococcal capsular polysaccharide vaccine may not work in the individuals, who need it most, AIDS patients and patients of lymphoma, due to poor IgG responses.
What is the recommendation schedule of vaccine?
The pneumococcal capsular polysaccharide vaccine is recommended in the above mentioned individuals every five years, as the antibody levels decline with time. Although some recommends getting only single booster vaccine after five years.