Who should get the vaccine?
It is recommended for everyone 65 years of age and older as well as anyone wtih chronic conditions, such as diabetes, lung conditions like asthma, heart disease, liver disease, kidney disease, sickle cell disease, and alcoholism. Of course, people who have some sort of immunocompromise—leukemia, lymphoma, or if they don't have a spleen, or their spleen doesn't work—should get the pneumococcal vaccination as well. People who have HIV or AIDS are candidates. People who have had cochlear implants or have spinal fluid leaks—a small but very important group—should also get the vaccine. Almost two years ago, the Center for Disease Control opened up the indication for the pneumococcal vaccine to those who have asthma or smoke. So there is a huge number of people—over 70 million in the United States—who are candidates to receive the pneumococcal vaccine.
Are there any people who should not get the vaccine?
Only people who are allergic to the vaccine or one of its components, but those people are very rare.
Are there any risks or side effects associated with the vaccine?
The most common side effect with pneumococcal vaccination is soreness and sometimes even swelling of the arm where the injection takes place. Occasionally people have fever or flu-like symptoms related to the vaccine, but these are transient and resolve on their own.
How often does the vaccine need to be administered?
Unlike the influenza vaccine, which needs to be given yearly, the pneumococcal vaccine is either a one-time vaccine or, in some cases, a second vaccine is given five years after the first. This is for patients in certain risk groups. You should ask your doctor if you should have an additional follow-up vaccine.
Is there a lack of awareness about the pneumococcal vaccine?
The National Foundation for Infectious Diseases conducted a survey of consumers this past summer about their awareness of various vaccines. We found that the degree of awareness was higher for all vaccines except the pneumococcal vaccine. For example, in our survey there was a growth in awareness of the influenza vaccine of about 78 percent. The growth of awareness of the pneumococcal vaccine was only 20 percent.
What can be done to encourage people to receive the vaccine?
The biggest things is awareness. We looked at the Healthy People 2010 goals for pneumococcal vaccination and we didn't do all that well. If you look at the age group 65 and older, among Caucasians about 65 percent of people got the vaccine. Among African Americans, about 45 percent got it. Among the Hispanic population, about 40 percent got. Our goal was for 90 percent of people to receive the vaccine. The overall average for the 65 and older group was 60 percent. If you look at the 19 to 64 year old age group, it really wasn't very good. For 2009, overall 17.5 percent of people who should have gotten the pneumococcal vaccine actually got it—so less than one-fifth of the people in that age group who are candidates for the vaccine. So we have a lot of work to do to make sure that people who are in this age group and risk group, particularly people with diabetes, are aware of the availability of the vaccine and the fact that they should get it.
Is there any additional advice for people with diabetes?
If their physician or healthcare provider doesn't talk about vaccines, specifically the pneumococcal vaccine, at the time of one of their routine visits, people with diabetes should ask about it. Doctors can get busy in the midst of a clinic with treating the problem at hand and taking care of routine immunizations is something that can get passed over. Most doctors and most practices really welcome the opportunity to discuss the topic of vaccines when patients bring it up. They are more and more aware of the need for routine vaccinations among all adults, and people with chronic conditions such as diabetes need to be even more vigilant.
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As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...