What Is Pneumococcal Disease?
It’s an infection caused by bacteria that can lead to pneumonia, meningitis, or bloodstream infections. People with lupus are at higher risk for these serious illnesses. The most common bacterial pneumonia is pneumococcal pneumonia, caused by streptococcus pneumoniae bacteria, also called pneumococcus, and the lung infection with pneumonia is called strep pneumonia.
Why Is It Important For People With Lupus?
Getting this vaccine helps protect you from dangerous infections. Since lupus weakens your immune system, it’s important to be vaccinated. People with SLE are 2 to 6 times more likely to have infections such as pneumonia compared to healthy people.
Invasive pneumococcal infection in SLE is 13 times higher than in the general population.
Is It Given More Than Once?
It depends on which pneumococcal vaccine is being administered. There are now two types of pneumococcal vaccines:
Prevnar 20 (PCV20)
Prevnar 20 is a conjugate vaccine, offering broader and potentially longer-lasting protection against more serotypes compared to Pneumovax 23 (PPV23). Prevnar 20 is generally recommended for adults 65 and older, and for those 19–64 with certain risk factors. This is the preferred pneumococcal vaccination in Canada. For most adults who have not been vaccinated, Prevnar 20 is the only vaccine needed (but rarely in very high-risk adults, Prevnar 20 and Pneumovax 23 may both be given). It is given once.
Pneumovax 23 (PPV23)
Pneumovax 23 is a polysaccharide vaccine that can be offered if Prevnar 20 is not available. Pneumovax 23 is recommended for adults 50 and older and those 2 years and older with increased risk. This may be given once or rarely given a second time.
For those who received pneumococcal vaccines as adults already, consult with your health care provider to see if you need the newer vaccine (Prevnar 20).
Should I Get It?
Yes. Your doctor will tell you whether you need just one dose or additional doses, depending on your health.
There are circumstances when you should get the Prevnar 20 vaccine before you are 65. For instance, if you are taking strong immune suppressive drugs for your SLE such as high doses of prednisone, if you are using rituximab, other strong immune suppressive drugs, if you have had your spleen removed or it is not functioning, and/or if you have a kidney transplant or are on dialysis, you should be vaccinated.
It is uncertain if all people with SLE who don’t have the aforementioned circumstances should be vaccinated before the age of 65, but it is safe to vaccinate earlier and the immunity is perceived to be lifelong in adults receiving Prevnar 20, but it may not be reimbursed by the provincial health plan if you are under 65.
It’s best to get vaccinated when your lupus is well-controlled. Discuss the timing with your healthcare provider.
When Should I Get It?
It’s best to get vaccinated when your lupus is well-controlled. Discuss the timing with your healthcare provider.
Are There Side Effects?
Most people have minor side effects, such as soreness or swelling at the injection site or mild fever. Serious side effects are rare.
Can It Cause Lupus To Flare?
It’s very unlikely. Protecting yourself from pneumonia is important to stay healthy.
Authors: Daniel Tingey and Doctor Janet Pope
Note: Please consult your healthcare provider or local health authorities for up-to-date vaccine recommendations.