What are the pneumonia vaccine guidelines for adults with asthma (Asthma) based on age?

From the Guidelines

Adults with asthma should receive the pneumococcal conjugate vaccine (PCV21, PCV20, or PCV15) followed by the pneumococcal polysaccharide vaccine (PPSV23) at least one year later, regardless of their age, as recommended by the most recent guidelines 1. The pneumococcal vaccine guidelines for adults with asthma are based on the risk of pneumonia and its complications.

• Asthma is considered a chronic lung disease that increases the risk of pneumonia, and therefore, adults with asthma are recommended to receive the pneumococcal vaccine earlier than those without asthma.
• The recommended vaccine schedule for adults with asthma under 65 years old is a single dose of PCV21, PCV20, or PCV15, followed by a single dose of PPSV23 at least one year later, as stated in the guidelines 1.
• For adults with asthma aged 65 and older, the guidelines recommend a single dose of PCV21, PCV20, or PCV15, and if PCV15 is used, a single dose of PPSV23 should be administered at least one year after the PCV15 dose 1. Some key points to consider when vaccinating adults with asthma include:
• The importance of completing the recommended pneumococcal vaccine series to ensure optimal protection against pneumonia.
• The need to review pneumococcal vaccine recommendations again when the patient turns 65 years old, as the vaccine schedule may change at that time.
• The possibility of using alternative vaccine schedules, such as PCV20, for adults with asthma who have not yet received a final dose of PPSV23, as recommended by the guidelines 1. It is essential to discuss the specific vaccination schedule with a healthcare provider, as recommendations may be adjusted based on the individual's medical history and other risk factors 1.

From the Research

Pneumonia Vaccine Guidelines for Asthma Patients

• The American Advisory Committee on Immunization Practices recommends pneumococcal vaccination for adults with asthma, considering them a high-risk category for invasive pneumococcal disease (IPD) 2.
• A study calculated the number needed to vaccinate (NNV) to prevent one case of IPD in asthmatics, finding that the NNV for pneumococcal conjugate vaccine (PCV)-13 or 23-valent pneumococcal polysaccharide vaccine (PPV-23) in asthmatic children and adults is comparable to that of other high-risk conditions, such as age ≥65 years 2.

Age-Based Recommendations

• The Advisory Committee on Immunization Practices (ACIP) recommends a single dose of pneumococcal conjugate vaccine (PCV) for all PCV-naïve adults aged ≥50 years 3.
• Adults aged 19-49 years with risk conditions, including asthma, should follow previous recommendations for PCV vaccination 3.

Vaccination Strategies

• Sequential administration of PCV followed by 23-valent pneumococcal polysaccharide vaccine (PPSV23) or revaccination with PPSV23 can elicit robust immune responses without evidence of hyporesponsiveness 4.
• PPSV23 vaccination of at-risk adults, including those with asthma, is essential to ensure broad protection against all 23 vaccine serotypes 4.

Adherence to Vaccination Recommendations

• A study found that 93% of adult patients with asthma in Poland did not receive pneumococcal vaccination, highlighting the need for education on the benefits of vaccination 5.
• Lack of information, lack of faith in vaccine efficacy, and fear of adverse effects were common reasons for not receiving the vaccine 5.

Updated Guidelines and Practice

• National guidelines have been updated to incorporate new pneumococcal vaccines, including PCV15 and PCV20, into clinical practice 6.
• Utilizing both conjugate and purified polysaccharide modalities in series can produce greater and lasting immunity against pneumococcal disease 6.