Adult Smokers Need Pneumococcal Vaccine

CDC Committee Recommends Vaccine Because of Smokers' Pneumococcal Pneumonia Risk

By Daniel J. DeNoon
WebMD Health News

Reviewed By Louise Chang, MD

Oct. 22, 2008 -- All adult cigarette smokers should get the pneumococcal vaccine, the CDC's vaccine advisory committee today recommended.

The panel previously recommended that as of 2009, adults with asthma should get the vaccine. Adults aged 65 or over, and those with chronic illness, are already advised to get the vaccine.

But more than half of serious invasive pneumococcal diseases occur in people who smoke cigarettes.

Smoking just one cigarette a day doubles pneumococcal pneumonia risk. There's nearly a fourfold higher risk in those who smoke 15 to 24 cigarettes a day. More than 24 cigarettes a day increases risk 5.5-fold.

Risk increases with years of smoking and number of packs of cigarettes smoked.

During its deliberations, members of the CDC's Advisory Committee on Immunization Practices (ACIP) wondered whether risk could already be elevated in 19-year-old smokers. Nevertheless, the panel voted to make a clear recommendation for all smokers, advising the vaccine for all smokers aged 19 and older.

Doctors who offer the vaccine to smokers, the panel said, should also offer counseling on quitting smoking.

Currently, vaccination with pneumococcal polysaccharide vaccine is recommended for:

• All adults 65 or older
• Everyone 2 and older with chronic medical conditions such as diabetes, chronic lung, heart, kidney or liver disease, or alcoholism
• People over 2 whose immune systems have been weakened by such conditions as cancer or HIV infection
• People without a functioning spleen
• People with sickle cell disease

The CDC usually follows the recommendation of the ACIP.

SOURCES: Meeting of the Advisory Committee on Immunization Practices, Oct. 22, 2008. Nuorti, J.P. The New England Journal of Medicine, March 9, 2000; vol 342: pp 681-689. Sheffield, J.V.L. and Root, R.K. The New England Journal of Medicine, March 9, 2000; vol 342: pp 732-734.

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