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Q: Could you please tell me how often a person should get the pneumonia shot? I have heard three different answers from medical personnel: once in a lifetime, twice in a lifetime and every five years. I'm confused.
A: It seems that guidance on the pneumonia vaccination has been a moving target in recent years, and it is confusing. Here's my understanding of the latest recommendations:
Get the pneumonia shot if you:
-Are 65 years or older.
-Have a chronic disease (heart disease, lung disease, diabetes, etc.)
-Have a weakened immune system due to disease or drug treatment.
-Are healthy and wish to avoid getting pneumonia or spreading it to high-risk individuals.
Get a one-time booster shot (revaccination) if you:
-Are 65 years or older and received your initial pneumonia shot before you turned 65.
-Have chronic renal failure or nephrotic syndrome or a suppressed immune system.
Note: The booster shot should be given at least five years after the initial shot. Those older than 65 who got the initial shot at age 63, for example, are eligible for a booster shot at age 68. If you're older than 65 when you get your initial shot, no booster is recommended.
Hope that helps.
Q: You wrote that persons with a history of Guillain-Barre syndrome should ask their physicians about possible alternatives to the flu shot. One of my physicians has diagnosed my nerve condition as chronic GBS (Guillain-Barre Syndrome) but another categorizes it as CIDP (chronic inflammatory demyelinating polyneuropathy). I am uncertain about whether I should get a flu shot (although I have been getting it for years). What do you think?
A: Your doctors appear to be talking about the same disease. Guillain-Barre syndrome is an acute nerve disorder that causes fever, nerve damage, and muscle weakness. The chronic form of the disease is called CIDP.
Concern about a possible association between GBS and the flu shot first surfaced in 1976 with the swine flu vaccine. With that vaccine, the risk of developing GBS within 2-3 months of getting the shot was about 10 cases per million people vaccinated - an estimated five to six times higher risk compared to unvaccinated people.
Since then, flu vaccines have not been associated with a significantly increased risk of GBS.
This apparently slight risk should be weighed against the risk of the flu.
For people at high risk for flu-related complications in particular, the flu poses a greater potential danger than GBS.
You seem to have been getting a yearly flu shot with no apparent problems.
However, since you already have GBS in its chronic form, it would be best to talk to your physicians about this.
(Richard Harkness is a consultant pharmacist who writes on health care topics. You can write him at 1224 King Henry Drive, Ocean Springs, MS 39564. His e-mail address is email@example.com. Volume of mail prohibits individual replies; selected letters will be answered in his column.)
(c) 2003, The Sun Herald (Biloxi, Miss.). Distributed by Knight Ridder/Tribune News Service.