My patient has been hospitalized for pneumonia several times by different physicians. He has never received the pneumococcal vaccine. Can this vaccine begiven during the patient’s hospital stay?
My patient has been hospitalized for pneumonia several times by different physicians.He has never received the pneumococcal vaccine. Can this vaccine begiven during the patient's hospital stay? If not, how soon after discharge can it beadministered? Should the patient be immunized again after 5 to 10 years?
Pneumococcal vaccine can be given to patientswhile they are still in the hospital recovering frompneumonia--preferably at discharge. Pneumococcalvaccine is recommended for the followinggroups of patients:
Whether because of age or because of other factors,your patient appears to be at increased risk for pneumonia.Thus, he should receive influenza vaccine as well aspneumococcal vaccine. Both vaccines can be given on thesame day at different sites.If your patient is younger than 50 years, carefully reviewrisk factors for pneumococcal infection (cardiovasculardisease, pulmonary disease, diabetes, alcoholism, cirrhosis,HIV infection) and initiate treatment for these ifnecessary.If your patient is immunosuppressed or younger than50 years at the time of initial vaccination, he should be revaccinatedin 5 years. Revaccination after less than 2 yearsis more likely to result in a reaction. There are no dataabout a third course of vaccine, but most authorities thinkit is not needed.
-- Darwin Palmer, MD
Professor of Medicine, Emeritus
Division of Infectious Diseases
University of New Mexico School of Medicine