obody wants to get sick, and an ounce of prevention is worth a pound of cure. But when it comes to one of the most common and dangerous illnesses that older Canadians can contract, far too few of us are taking the simple step of getting vaccinated. I’m talking about pneumococcal disease, which often manifests as pneumonia.

We have two vaccines against pneumococcal disease in Canada: a polysaccharide vaccine that protects against 23 strains of pneumococcus bacteria, and a conjugate vaccine that provides additional protection against 13 of the most common strains. Both vaccines are now recommended for use by the National Advisory Committee on Immunization (NACI), but the uptake among the at-risk population is well below their targets.

“Right now, NACI recommends that all people over the age of 65 get the polysaccharide vaccine, which is what we have always done,” says Dr. Shelly McNeil, Chair of Immunize Canada. “What’s new is that, due to evidence showing that the conjugate vaccine can in some cases cause better immune responses in adults and can specifically prevent pneumonia, they are now recommending adults over 65 get both vaccines — first the conjugate vaccine and then, eight weeks later, the polysaccharide.” Unlike the flu shot, which needs to be given annually, for most adults 65+ this sequence is considered “one and done.”

Canadians under 65 at risk as well

In addition to the blanket recommendation for those over 65, NACI also recommends vaccination for many at-risk adults below that age range. “All adults are susceptible to pneumococcal infections, but the people most at risk are those who are immuno-compromised, either due to an underlying medical problem like cancer or due to medications that can suppress the immune system,” explains Dr. Allison McGeer, Director of Infection Control at Mount Sinai Hospital in Toronto. “Adults under the age of 65 who have chronic medical conditions of almost any sort — like heart disease, lung disease, or diabetes — are advised to get the polysaccharide vaccine. But people under 65 who are in any way immuno-compromised should be getting both vaccines.”

The consequences of not getting vaccinated can be profound. Pneumonia is scarier than many of us realize, especially as new strains are becoming more resistant to antibiotics. “Pneumonia is a really common disease, and so people don’t see it as being that dangerous,” says Dr. McGeer. “But it’s one of the leading causes of hospitalization and death in Canadian adults. It’s so severe that people who survive pneumonia can go from living independently to needing to live with care, never recovering completely.”

Reducing risk is possible

The good news is that the vaccines work. When Ontario first started publicly funding pneumococcal vaccines in 1995, a 20 percent reduction in severe pneumococcal disease among older adults was seen in just two years. And a large clinical trial comparing the conjugate vaccine to a placebo in people over the age of 65 saw a 45 percent reduction in vaccine-type pneumococcal community-acquired pneumonia in the vaccinated group.

This success rate is why it’s so important all older Canadians talk to their doctors and make sure they are being vaccinated according to the NACI recommendations. No matter how healthy you feel today, your age puts you at risk simply because our immune systems grow weaker as we age. “It can be difficult as you get older to acknowledge that you are at greater risk,” says Dr. McGeer. “But the people who are going to regret it if you don’t get vaccinated are your friends and your children. There’s no reason not to get these vaccines.” Naturally, you should speak with your health care professional prior to immunization.