Should People With Asthma Get the Pneumonia Vaccine?

Changes in immunization recommendations for vaccination against pneumococcus
Until recently, there were well-founded recommendations that individuals with the disorders mentioned above get vaccinated at an early age (before age 65) with the pneumococcal vaccine (‘the pneumonia vaccine'). Notably, people with chronic asthma were excluded from this list, as there was no evidence to show that it was effective. This has changed due to a recent study that showed that individuals who developed severe/life-threatening pneumococcal infections were more likely to have asthma. The researchers performed a review of serious pneumococcal cases in a large Minnesota county and compared these to individuals that did not have serious pneumococcal disease who were matched by gender and birthday (also living in the same county). The researches found that all individuals with serious pneumococcal infections were nearly 2.5 times more likely to have asthma. When they looked at adults, those with severe pneumococcal disease were nearly 7 times more likely to have asthma. These results demonstrated that asthmatics, especially adult asthmatics, are significantly more likely to get severe infections from pneumococcus.

With these recent results in hand, the ACIP of the CDC changes their formal recommendations for immunization against pneumococcus - in late 2008 they released a preliminary amendment to their prior recommendations that now includes asthma as a predisposing condition for which adults (age >19) should receive the pneumonia vaccine. This modification will be included in the ACIP 2009 Recommended Adult Immunization Schedule, to be released in January 2009.

Closing thoughts

While it is not clear that asthmatics have a weaker immune system (as does someone without a spleen), it is now clear that there are features of the airways in asthmatics that not only predispose them to pneumococcal infection, but especially more severe infection. You should ask your doctor about whether the pneumonia vaccine is right for you.