Vaccination Update March 2023: “Pneumonia Jab”
Infections, such as pneumonia, can seriously impact on the symptoms experienced, quality of life and overall health of all patients with Neuroendocrine Cancer – particularly those with DIPNECH and/or a Lung Primary, those who may have had their spleen removed and/or those with reduced/lowered immunity.
Infection can lead to cancer treatments, such as surgery, radionuclide therapy (PRRT) or chemotherapy, being delayed, halted, or prevented.
Pneumococcal infections are potentially serious, they can lead to hospitalisation and may be life- threatening.
Prevention or reducing risk is advised.
The pneumococcal vaccine offers protection against serious and potentially fatal pneumococcal infections: pneumonia, sepsis +/- meningitis.
Though it’s more commonly known as the pneumonia vaccine.
Unlike the flu, there’s no such thing as pneumonia or pneumococcal season. Therefore, if you and your doctor decide that you need to have a pneumonia vaccine, you can get it done at any time of the year.
If it happens to be flu season, you can get a pneumonia vaccine at the same time as you get your ‘flu jab’.
The NHS advises that there are 4 groups of people who are advised to get vaccinated against pneumococcal infections:
- people aged 65 and over
- anyone from the ages of 2 to 64 with a health condition that increases their risk of pneumococcal infection
- anyone at occupational risk, such as welders
If you’re 65 or over, you should be offered a type of pneumococcal vaccine known as the pneumococcal polysaccharide vaccine (PPV). This one-off vaccination is very effective at protecting you against serious forms of pneumococcal infection.
The PPV vaccine is available on the NHS for children and adults aged from 2 to 64 years old who are at a higher risk of developing a pneumococcal infection than the general population.
You’re considered to be at a higher risk of a pneumococcal infection if you have:
- had your spleen removed, your spleen does not work properly, or you’re at risk of your spleen not working properly in future (for example, if you have coeliac disease)
- a long-term respiratory disease, such as chronic obstructive pulmonary disease (COPD)
- heart disease, such as congenital heart disease
- chronic kidney disease
- chronic liver disease, such as liver cirrhosis
- a suppressed immune system caused by a health condition, such as HIV
- a suppressed immune system caused by medicines, such as chemotherapy or steroid tablets
- a cochlear implant (a hearing device)
- had a leak of cerebrospinal fluid (the clear fluid that surrounds the brain and spine) – this could be the result of an accident or surgery
Some people with an occupational risk are advised to have the pneumococcal vaccine, including those who work with metal fumes, such as welders.
Your doctor (GP or medical team) might suggest that you have the pneumococcal vaccine if your immunity is low or you are thought to be at higher risk, than the general population, of developing pneumonia.
There are two different types of pneumococcal vaccine. Neither are live vaccines, they do not contain any live organisms, so cannot cause the infections they protect against. These are the:
- pneumococcal polysaccharide vaccine (PPV)
- pneumococcal conjugate vaccine (PCV)
If you’re at increased risk of a pneumococcal infection, you’ll be given a single dose of the PPV vaccine.
However, if your spleen does not work properly or you have a chronic kidney condition, you may need booster doses of PPV every 5 years.
Adults and children who are severely immunocompromised (including anyone with leukaemia, multiple myeloma, genetic disorders affecting the immune system, or after a bone marrow transplant) usually have a single dose of PCV followed by PPV.
You may also require both if you are due to have your spleen removed (a splenectomy) or your spleen is not working well/has been removed.
When should you have the pneumococcal vaccine.
As previously mentioned, unlike the flu, there is no pneumococcal season. Therefore, the pneumococcal vaccine is available at any time of the year.
Check with your doctor when it is best to have it in your situation.
The NHS advises that you should have the vaccine at least 2 weeks before having your spleen removed.
Or 2 weeks before starting chemotherapy or radiotherapy.
If you did not receive a pneumococcal vaccination before treatment, you could have it afterwards. But you should wait at least 3 months after cancer treatment has finished.
Check with your specialist about the best time. This might vary depending on your situation.
For example, leukaemia patients should have PCV from 6 months after chemotherapy. Those who have had a stem cell or bone marrow transplant should have PCV around 9 to 12 months after their transplant.
You need to have PPV every 5 years if you have had your spleen removed, or your spleen is not working well.
Who should NOT have the pneumococcal vaccine
Vaccine allergy: If there’s been a confirmed severe allergic reaction (anaphylaxis) to the pneumococcal vaccine or any ingredient in the vaccine, it may not be possible for you to have it.
But if it was only a mild reaction, such as a rash, it’s generally safe to have the vaccine.
Please speak with your GP and any other medical staff (clinic/hospital) – to ensure the allergy is documented in your medical notes.
Fever at the vaccination appointment: If you or your child are mildly unwell at the time of the vaccination, it’s safe to have the vaccine. But do let the vaccination team know, so that they can check your temperature and symptoms. to ensure that you are well enough to go ahead.
However, if you or your child are more seriously ill (for example, with a high temperature and feeling hot and shivery), it’s best to delay the vaccination until after recovery.
Pregnancy and breastfeeding: Having the pneumococcal vaccine is thought to be safe during pregnancy and while you’re breastfeeding.
But as a precaution, you may want to wait until you’ve had your baby if you’re pregnant, unless the benefits of having the vaccine outweigh the risks to your child.
Side effects of the pneumococcal vaccine in adults
Mild side effects of the pneumococcal polysaccharide vaccine (PPV), the version of the pneumococcal vaccine given to adults and children over the age of 2, include:
- mild soreness or hardness at the site of the injection lasting 1 to 3 days
- a slightly raised temperature
More serious side effects of the PPV vaccine, such as allergic reactions (anaphylaxis), are rare.
Anaphylaxis is a rare, serious side effect that can happen within minutes of the injection. It’s very alarming at the time, but it can be treated with adrenaline.
For those with Carcinoid Syndrome – who may be concerned about the use of adrenaline, please note that the life-saving treatment of anaphylaxis takes priority over the possible risk of carcinoid crisis.
The doctor or nurse giving the vaccine will have been trained to know how to treat anaphylactic reactions.
Reporting side effects of the pneumococcal vaccine
The Yellow Card Scheme allows you to report suspected side effects from any type of medicine you’re taking or vaccines you have received.
It’s run by a medicines safety watchdog called the Medicines and Healthcare products Regulatory Agency (MHRA).
See the Yellow Card Scheme website for more information.
Resources and further information:
NHS Inform Scotland: https://www.nhsinform.scot/healthy-living/immunisation/vaccines/pneumococcal-vaccine
HSC Public Health Agency Northern Ireland: https://www.publichealth.hscni.net/publications/pneumococcal-vaccine-helping-protect-against-pneumonia-meningitis-and-other-serious