Wednesday, November 26, 2003

When to get pneumonia shots

By RICHARD HARKNESS
Knight Ridder Newspapers

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 drugs.

• 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.

Q. 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. What do you think?

A. 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.

However, since you already have GBS in its chronic form, it would be best to talk to your physicians about this.