Adult smokers urged to get pneumococcal vaccine

10/23/2008

ATLANTA - For the first time, an influential government panel is recommending a vaccination specifically for smokers.

The panel decided yesterday that adult smokers under age 65 should get pneumococcal vaccine. The shot - recommended for anyone 65 or older - protects against bacteria that cause pneumonia, meningitis, and other illnesses.

Federal officials usually adopt recommendations made by the panel, the Advisory Committee on Immunization Practices. The vote means more than 31 million adult smokers probably soon will be called on to get the shot.

Studies have shown that smokers are about four times more likely than nonsmokers to suffer pneumococcal disease. Also, the more cigarettes smoked each day, the higher the odds the smoker will develop the illness.

Why smokers are more susceptible is not known for sure, but some scientists believe it has to do with smoking-caused damage that allows the bacteria to attach easier to the lungs and windpipe, Dr. Pekka Nuorti, a medical epidemiologist with the Centers for Disease Control and Prevention, said.

Pneumococcal infections are considered the top killer among vaccine-preventable diseases. It's a common influenza complication, especially in the elderly, and is considered responsible for many of the 36,000 annual deaths attributed to flu.

The committee voted 11-3 to pass the recommendation, with one member abstaining. The panel added a call for smoking-cessation counseling.

Some members said it might be more cost effective to recommend the vaccine for smokers who were at least 40, because pneumococcal disease is relatively rare in younger smokers.

Dr. James Turner, who oversees student-health programs at the University of Virginia, said about one college student in five is a smoker, but he never has seen a case of serious pneumococcal disease in a student.

"I wonder how many young people are truly benefiting from this" advice, he said, speaking as an American College Health Association representative.

The shot is not perfect. First licensed in 1983, it is designed to protect against 23 strains of pneumococcal bacteria. But it hasn't proved effective against pneumonia or in warding off other pneumococcal illnesses in people with weakened immune systems and people 80 or older.

It's to be given to smokers as a one-time dose with no booster, but its protection drops off after 5 to 10 years. Made by Merck & Co., it's sold under the trade name Pneumovax and costs about $30 a dose.