From the Guidelines
Patients with mild exercise-induced asthma generally do not need pneumonia vaccines before age 50 unless they have additional risk factors. The pneumococcal vaccine is typically recommended for adults aged 65 and older or for younger individuals with specific conditions like severe asthma requiring regular oral steroids, immunocompromising conditions, chronic lung diseases (beyond mild asthma), heart disease, diabetes, or liver disease 1. Mild exercise-induced asthma alone doesn't significantly increase pneumonia risk to warrant early vaccination. However, these patients should receive their annual influenza vaccine, as the flu can trigger asthma exacerbations. If the asthma becomes more severe, requires frequent oral steroid use, or if additional risk factors develop, pneumococcal vaccination might become appropriate before age 50. Some key points to consider include:
- The Advisory Committee on Immunization Practices (ACIP) recommends pneumococcal vaccination for adults with certain medical conditions, but mild asthma is not typically considered a high-risk condition for pneumococcal disease 1.
- The ACIP guidelines emphasize the importance of vaccinating adults aged 65 and older, as well as younger adults with certain medical conditions, against pneumococcal disease 1.
- Patients with mild exercise-induced asthma should discuss their individual risk profile with their healthcare provider, as recommendations may change based on their specific health situation and updated guidelines. It's also worth noting that the guidelines for pneumococcal vaccination have evolved over time, with newer recommendations emphasizing the use of conjugate vaccines like PCV20 and PCV15 1. However, the fundamental principle of targeting vaccination efforts towards those at highest risk of pneumococcal disease and its complications remains unchanged.
From the Research
Pneumococcal Vaccination for Patients with Mild Exercise-Induced Asthma
- The Advisory Committee on Immunization Practices (ACIP) recommends a single dose of pneumococcal conjugate vaccine (PCV) for all PCV-naïve adults aged ≥50 years 2.
- There is no specific recommendation for patients with mild exercise-induced asthma to receive the pneumococcal vaccine before age 50.
- However, adults with asthma are considered to be at high risk for pneumococcal disease, and vaccination is recommended for those aged ≥50 years or with certain underlying medical conditions 3.
- The number of individuals with asthma that need to be vaccinated to prevent one case of invasive pneumococcal disease (IPD) is estimated to be around 355 to 1532 in low-risk adults and 195 to 839 in high-risk adults, assuming a vaccine efficacy of 65% 3.
Exercise-Induced Asthma and Pneumococcal Vaccination
- Exercise-induced asthma (EIA) is a condition that affects 50-60% of patients with asthma, and its severity can be reduced with treatment 4.
- While there is no direct link between EIA and pneumococcal vaccination, patients with asthma are considered to be at high risk for pneumococcal disease.
- Pneumococcal conjugate vaccines (PCVs) have been shown to induce a T cell-dependent immune response and provide an extended duration of protection with repeated vaccinations 5.
- Co-administration of PCV13 and quadrivalent inactivated influenza vaccine (QIV) has been shown to be safe and effective in adults ≥50 years old preimmunized with ≥1 dose of 23-valent pneumococcal polysaccharide vaccine (PPSV23) 6.