Risk factors

Age is not the only risk factor: A wide range of conditions can make patients more vulnerable to pneumococcal pneumonia
Pneumococcal pneumonia risk rates vs healthy 18- to 64-year-olds2*
  • The CDC’s ACIP recommends Prevnar 13® for immunocompetent adults aged 65 and older based on the shared clinical decision-making of the provider and patient, as well as adults aged 19 and older with certain immunocompromising conditions,§ functional or anatomic asplenia,| | CSF leaks, and cochlear implants
  • There is no Prevnar 13® recommendation for immunocompetent adults aged 19-64 with certain chronic conditions, including chronic heart disease, chronic lung disease, diabetes mellitus, alcoholism, chronic liver disease, in addition to current smokers; the CDC’s ACIP has not formally evaluated this policy question3,4
HIV=human immunodeficiency virus.
*Data from a retrospective cohort study from 3 large, longitudinal, US healthcare databases of medical and outpatient pharmacy claims from 2007-2010.2
Risk ratios were calculated using rates of pneumococcal pneumonia among healthy adults aged 18-64 as a baseline (17.6 cases per 100,000 person-years).2
Defined as malignant neoplasms or solid organ transplantations associated with immunosuppressive agents or radiation therapy.2
§Congenital or acquired immunodeficiencies, HIV, chronic renal failure, nephrotic syndrome, leukemia, lymphoma, Hodgkin disease, generalized malignancy, iatrogenic immunosuppression (diseases requiring treatment with immunosuppressive drugs, including long-term systemic corticosteroids and radiation therapy), solid organ transplant, multiple myeloma.3
| |Including sickle cell disease/other hemoglobinopathies and congenital or acquired asplenia.3
References:
  1. Matanock A, Lee G, Gierke R, Kobayashi M, Leidner A, Pilishvili T. Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among adults aged ≥65 years: updated recommendations of the Advisory Committee on Immunization Practices. MMWR Morb Mortal Wkly Rep. 2019;68:1069-1075. doi: http://dx.doi.org/10.15585/mmwr.mm6846a5.
  2. Centers for Disease Control and Prevention. Updated recommendations for prevention of invasive pneumococcal disease among adults using the 23-valent pneumococcal polysaccharide vaccine (PPSV23). MMWR Morb Mortal Wkly Rep. 2010;59(34):1102-1106.
  3. Centers for Disease Control and Prevention. Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine for adults with immunocompromising conditions: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2012;61(40):816-819.
  4. Shea KM, Edelsberg J, Weycker D, Farkouh RA, Strutton DR, Pelton SI. Rates of pneumococcal disease in adults with chronic medical conditions. Open Forum Infect Dis. 2014;1-9. doi:10.1093/ofid/ofu024.