Protection Against Pneumococcal Pneumonia In The Elderly

The bacterium behind pneumococcal disease, S. Pneumoniae, is a leading cause of community-acquired pneumonia, otitis media (inner ear infection), meningitis (inflammation of the brain lining) and bacteremia (blood infection)[1]

It can be life threatening, yet it is significantly under-recognised globally, including Malaysia. Pneumonia is the most common form of pneumococcal disease and is one of the leading causes of morbidity amongst adults in Asia[2].

According to the latest World Health Organization (WHO) data published in April 2011, influenza and pneumonia deaths in Malaysia reached 9,417 or 9.20% of total deaths – influenza and pneumonia is the number three killer behind coronary heart disease and stroke.

Globally, pneumococcal disease has been recognised as a leading cause of death in adults – in 2002, there were 896,000 deaths in adults worldwide due to pneumococcal disease [3] [4].


Pfizer’s Pneumococcal Conjugate Vaccine, Prevenar 13, is now indicated for adults 50 years of age and older for active immunisation for the prevention of invasive Pneumococcal caused by the Streptococcus pneumonia (S. Pneumoniae) bacteria[5].

This approval coincides with U.S. FDA’s approval of the new indication for the vaccine in January 2012 that was based on safety and immunogenicity studies involving approximately 6,000 adults 50 years of age and older. Administered as a single dose, it provides long term protection from pneumococcal disease.

Prevenar 13 uses conjugate technology which activates several pathways into the immune system, and is believed to induce immune memory which helps the immune system remember the infection and provide sustained protection against it [6].

Age is a primary risk factor for pneumococcal disease and as Malaysia sees an increasing population of elderly people[7], it is crucial to support the healthy ageing of older adults.


Pneumococcal disease can affect people of all ages, but children younger than five and adults 65 years of age and older are at an increased risk [8] [9]. As people age, their immune system starts to decline6.

Due to this, people face increasing risk of infection as they get older6. Caretakers and grandparents who spend a lot of time with pre-school children are especially susceptible to getting infected as pneumonia is spread through contact with infected respiratory secretions[10].

The risk of pneumococcal disease in adults aged 50 and older also increases due to common conditions such as chronic heart, lung (including COPD and asthma), renal or liver disease, cancer, diabetes, or other risk factors such as smoking, alcoholism and living conditions such as long-term care residency3 6 [11].

Hajj and Umrah pilgrims over the age of 50 are also prone to contracting pneumonia during Hajj. Research confirms that pneumonia is the largest cause of hospitalisation of Hajj pilgrims during Hajj season, amounting to more than 19.7 percent hospitalisation rate[12].

The risk of pneumococcal disease is also extended to those suffering from respiratory tract infections (LRTIs)[13] – LTRIs are the third leading cause of death in the world[14].

If you are above 50 or have a parent who might be at risk, speak to your doctor today about getting protected for pneumococcal pneumonia.

This community message is brought to you by pfizer.

[1] Centers for Disease Control and Prevention. Prevention of pneumococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 1997;46(RR-8):1-24.

[2] Song J-H et al. Clinical and economic burden of community-acquired pneumonia amongst adults in the Asia Pacific region. Int J Antimicrob Agents (2011), doi: 10.1016/j-ijantimicag.2011.02.017

[3] World Health Organisation (WHO). 23 valent pneumococcal polysaccharide vaccine. WHO Position paper. Wkly Epidemiol Rec. 2008,83 (42): 373 – 384.

[4] World Health Organization (WHO). WHO Global Immunization data 2008.

[5] Product Information, Pneumococcal Polysaccharide Conjugate Vaccine (adsorbed), 13-valent. CDS ver 9.0 dated 22 August 2012, UK SPC dated 27th March 2012 and Australian PI dated 28 Oct 2011 (for adult indication only).

[6] Pfizer Data on File (DOF). Adult Prevnar 13 USPI. 2011.

[7] Weinberger B, Herndler-Brandstetter D, Schwanninger A, et al. Biology of immune responses to vaccines in elderly persons. Clin Infect Dis. 2008; 46: 1078-1084

[8] Centres for Disease Control and Prevention. Prevention of Pneumococcal disease: recommendations of the advisory committee on immunization practices (ACIP). Morb. Mortal Wkly Rep. 1997;46 (RR-8): 1-24.

[9] World Health Organisation. International Travel and Health. Chapter 6. Vaccine-preventable diseases and vaccines. 2010.

[10] Adapted from “Patient Information: Pneumonia in Adults (Beyond the Basics)”. Available at: Accessed on 3 October 2012.

[11] CDC. Prevention of Pneumococcal Disease: Recommendations of the Advisory Committee on Immunisation Practices (ACIP).

[12] Adapted from “Vaccination during Hajj,Umrah, Pfizer launches awareness campaign on Pneumonia” Available at : Accessed on 3 October 2012.

[13] Hak E et al. Arch Intern Med 2005; 165: 274-80

[14] WHO Global Burden of Disease Report, 2004 update.

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