quote:
The pneumovax, also called pneumococcal 23, is typically indicated for adults with certain medical conditions including diabetes, asthma, COPD, HIV, liver disease, kidney disease, etc between the ages of 18 and 64 years old. It is recommended for everybody 65 years and up.

Typically, we only give the vaccine once after the age of 65 and once before the age of 65 if they have any of the qualifying medical conditions.

It protects specifically against streptococcal pneumonia, a bacteria that is the most common cause of adult pneumonia.

Is it a good thing to have on board if you have any of those medical conditions or above the age of 65 and get covid? Probably.

I don't think it would cause any significant drop in complications or mortality, but a study would be interesting to see if there is a difference in outcomes.

Taking this a step further, the lady who cleans my office had some interesting questions about “pneumonia” and COVID, and she did not quite understand this. It’s a thing I take for granted when I talk about it, so sometimes I seem to forget what “normal” people know about things.

“Pneumonia” can be defined roughly as “fluid inside the air sacks and small airways of the lungs from an infectious origin.” It can be from Streptococcus pneumonia. It can by from staphylococcus aureus (especially in the setting of a recent viral illness). It can come from influenza itself. It can come from COVID itself. There are others, and the list is probably somewhere around 20-30 for “common” species causes of it.

Now, there are two available “pneumonia” vaccines. They are for Streptococcus pneumonia ONLY. This bacteria does plenty of non-pneumonia things (blood and spinal cord infections are probably nearly equally as common in the unvaccinated). There are about 30 strands of S pneumoniae. The vaccines cover 13 and 23 of the most common forms of the bacteria known to cause it (and many argue the 13 is actually a better vaccine than the 23 in terms of immunogenicity).
Along the same lines, there is a bacteria called Haemophilis influenza. It doesn’t cause influenza. There is a vaccine for it. It causes life-threatening swelling of the small flap of skin responsible for covering your “wind pipe” when you swallow, or epiglottitis. This point here meant to represent that the name of a bacteria doesn’t necessarily mean that it is the only cause of its disease process, and the name also doesn’t tell you the only thing the bacteria does.

So the big point at hand- nothing about the “pneumonia vaccine” will prevent anything about pneumonia from any cause other than strep/pneumococcus (it’s been given a nickname, too, to make it more confusing). When you hear about “COVID pneumonia,” you are almost always hearing about a viral pneumonia caused by the virus itself, for which there is no real preventative measures other than possibly/probably the COVID vaccine (while there isn’t enough data to make the claim, the number of patients whose illness does not progress after it does seem to suggest that in the future they can look back and say that it prevents it. But that’s my guess, not facts just yet, but I can all but assure you the cases of viral pneumonia are reduced in the vaccinated from what we know today, which is still early in the course of the virus (though hopefully about 3/4 through the “pandemic” portion of it)).

Now, very common with infleunza is what’s called a “post viral pneumonia” which is very often from staph. It has a fairly common though not truly diagnostic appearance on x-ray. I have only really seen that type of pneumonia once on a COVID patient, and the radiologist either didn’t agree with me or didn’t suspect it enough to write down that he thought that (and that’s an entirely different discussion). A lot of sick folks get coverage as if it’s a bacterial or secondarily bacterial or even fungal pneumonia, but most of them act as a viral one (ie, it doesn’t really respond to those treatments whereas bacterial ones usually respond pretty fast).

I hope this sheds some light and is at a decent comprehension level for folks here. I tried not to get too into the weeds or overly simplified. I can talk it a bit more up or down if anyone is interested. I shouldn’t have much going on today. Like most of my life.