Panel urges pneumococcal vaccine for smokers
A federal health panel for the first time has singled out smokers for vaccination because of their high risk of infection from a pneumonia-causing bacterium.
The national Centers for Disease Control and Prevention already recommends the pneumococcal vaccine for children, adults older than 65 and those with chronic illnesses and weakened immune systems.
The panel’s new recommendation, proposed Wednesday and expected to be formally adopted by the CDC, would expand the group to smokers ages 19 to 64.
About one-fifth of U.S. adults smoke cigarettes, according to CDC spokesman Curtis Allen. Studies consistently find that smokers account for approximately half of otherwise healthy adults with invasive pneumococcal disease, Allen said.
“The risk of getting pneumococcal pneumonia among smokers is substantially greater than among nonsmokers, so it makes sense to recommend that smokers get the vaccine,” said Dr. Norman H. Edelman, chief medical officer for the American Lung Association. “But that in no way protects you from all of the terrible things that smoking will do.”
The CDC committee also recommended Wednesday that smokers who receive the pneumococcal vaccine be advised to stop smoking. About 50 percent of regular smokers will die of a smoking-related disease, usually lung cancer, emphysema, chronic bronchitis or cardiovascular disease, Edelman said.
The vaccine protects against several strains of Streptococcus pneumoniae, a group of bacteria also known as pneumococci. They live intermittently in the noses and throats of people of all ages, usually without causing harm.
But in the wrong place, they can cause middle-ear and sinus infections as well as less common but more serious infections of the lungs, central nervous system and blood.
Smoking makes it easier for the bacteria to get to the wrong place by damaging protective mucous membranes and tiny, hair-like cilia in the back of the nose and throat, said Dr. Lisa Jackson, senior investigator for the Seattle-based Group Health Center for Health Studies. Smoking also damages the ability of white blood cells to fight infection, she said.
The bacterium is the most common cause of pneumonia acquired outside hospitals. It can infect the blood and the lining of the brain, causing meningitis. Studies have shown that the vaccine is effective at preventing those infections, Jackson said.
Pneumococcal blood infections are so severe that about 15 percent to 20 percent of patients die, even with treatment, said Dr. William Schaffner, an infectious-disease expert at Vanderbilt Medical Center in Nashville, Tenn.