Pneumococcus is a pathogenic bacterium that causes pneumonia, in addition to a variety of other potentially serious conditions. It spreads easily and can be deadly. According to the Public Health Agency of Canada, approximately five to seven percent of Canadians with pneumococcal pneumonia die, with the fatality rate being even higher among the elderly. It’s one of the most pervasive and dangerous vaccine-preventable diseases.

The pneumococcus vaccines are perhaps less well known than other vaccines like those for the flu or for measles, but they are considered by the World Health Organization to be among the most essential medicines in a basic health system.

"The National Immunization Coverage survey shows that less than half of all Canadians eligible for a pneumococcal vaccine have received one."

Are you high risk or highest risk?

Though pneumococcus immunization is not necessary for all healthy adults, the group of Canadians eligible for vaccination is still quite large.  The National Advisory Committee on Immunization (NACI), which provides guidelines to public health agencies in Canada, recommends a pneumococcal vaccine for anyone with asthma, diabetes, chronic heart disease, chronic lung disease, or chronic liver disease, as well as for adults living in long-term care facilities and anyone over the age of 65.

“There are two different kinds of vaccines for pneumonia,” explains Dr. Vivien Brown, President of the Federation of Medical Women of Canada and CFPC representative to Immunize Canada. “There are polysaccharide vaccines that cover 23 subtypes, which are recommended for everyone over 65.”

“The other vaccine is a conjugate vaccine,” continues Dr. Brown. “Conjugate vaccines provide a more aggressive immune response. This vaccine is not new and has been widely administered to infants for at least ten years, but only recently has it been recommended by NACI for specific use in some high risk adults.”

In Canada, taking a course of both vaccines is only recommended for those in the highest risk categories. “A highest risk person with, say, an immune deficiency or an underlying cancer would ideally take the conjugate vaccine then the polysaccharide vaccine in sequence to provide the best coverage,” says Dr. Brown. “One booster shot is recommended after five years.”

Between these two vaccines and the annual influenza vaccine (“You have to remember that influenza and pneumonia are partners in crime,” says Dr. Brown), we have a strong arsenal for defending against deadly pneumococcal infections. Unfortunately, the National Immunization Coverage survey shows that less than half of all Canadians eligible for a pneumococcal vaccine have received one.

Impact on quality of life

The result is that many Canadians are facing an unnecessary risk. For those over 65, pneumonia is a dangerous infection that could strike at any time and, even when it is not fatal, it can have long lasting effects on quality of life. Many who come down with the disease at this stage of their lives never fully recover. The lingering impact can be debilitating, making even climbing a set of stairs a permanent challenge.

What this means for older Canadians is that failure to vaccinate against pneumococcus can steal away their independence and rob them of the ability to enjoy their retirement. Traveling, golfing, and even playing with grandchildren can be permanently sidelined by a single illness. Too many people think of pneumonia primarily as something that kills the very old, and it is that, but for those in their mid-sixties who may have decades of good health and active living ahead of them, it still presents grave risks.

The most important thing is to speak to your doctor, nurse, or pharmacist about the right immunization program for you. Too many Canadians are unaware that they are at high risk for pneumonia or unaware that they can protect themselves from infection. With pneumonia and influenza combined being the sixth leading cause of death in Canada, it’s a conversation worth having.