Dear Dr. Donohue: Why does the medical profession tell us that folks over 70 do not need a pneumonia shot in the fall when they get their flu shots? Why do some say you should get the shot every year, while others say every other year, and some say every five years? Please clear up.
S.M.
The pneumonia shot is a vaccine for one kind of pneumonia, pneumococcal (NEW-moe-KOK-ul) pneumonia, the kind caused by the bacterium pneumococcus (NEW-moe-KOK-is). It's a very serious kind of pneumonia, one that often proves lethal for the elderly.
More than 90 strains of the pneumococcus bacterium exist. The adult vaccine currently in use affords protection against 23 of those strains. The name of the vaccine is Pneumovax 23. A single dose of the vaccine given to people age 65 and older is all the vaccine needed at the present time. No booster shots are recommended. However, a person who received the vaccine at an age younger than 65 does need a booster shot five years after the first shot was given.
These directions were formulated by a board of vaccine experts and are promulgated by the U.S. Centers for Disease Control and Prevention. Any changes will be passed to the public by this agency.
In 2010, a new pneumonia vaccine was introduced. It works against 13 strains of the bacterium. Its current target population is children. In December of 2011, it also was approved for adults older than 55. In June of 2012, it was approved for people age 19 and older whose immunity is not up to par. The name of this vaccine is PCV 13, Prevnar. This vaccine, while covering fewer strains, elicits a greater antibody response and affords more protection to the 13 strains contained in it. An expert panel might decide in the future to have this vaccine supplant Pneumovax 23 vaccine. That will not take place this year.
Dear Dr. Donohue: My husband had Alzheimer's disease. Years ago, they would say that older, confused people had hardening of the arteries. My grandpa was supposed to have had it. Is it the same?
M.S.
Alzheimer's disease is a degenerative disease in which a substance called amyloid infiltrates the brain and the brain fills with neurofibrillary tangles. Years ago, before Alzheimer's was recognized as such a common illness, older people with loss of mental function were said to have hardened arteries. Some people with dementia do have hardened arteries, but it's a much smaller number than used to be thought, and it comes nowhere near the number of cases of Alzheimer's disease.
