Can vaccines prevent pneumococcal infection at 55?

Question

Hello doctor,

I am 55 years old, and last month I was hospitalized for nine days due to severe pneumococcal disease, which my infectious disease specialist explained caused both pneumonia and an early bloodstream infection.

My temperature had reached 104 degrees Fahrenheit at home, and I became so confused that my husband had to call an ambulance. During my hospital stay, my white blood cell count was 22,000 cells/mm3, my CRP was 187, and a chest X-ray revealed consolidation in the right lower lobe. I was treated with IV Ceftriaxone, but my response was slow.

I have been diabetic for 12 years, and my HbA1c was 9.4 at the time of admission, which the doctors indicated lowered my immunity, making the pneumococcal infection more severe. Additionally, I have a history of splenectomy following an accident eight years ago, which apparently puts me at high risk for such infections. Now, both my pulmonologist and endocrinologist are involved in my follow-up care.

I had never received the pneumococcal vaccine before this episode, and I am confused as to why no one informed me that I needed it, considering my history with splenectomy. They are now discussing administering both PCV15 and PPSV23 vaccines.

I still experience some fatigue and a mild cough. I am concerned about the possibility of pneumococcal disease returning and would like to know what precautions I need to take going forward.

Please guide me.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and understand your concerns.

What you experienced was a severe invasive pneumococcal infection. In your case, the risk was higher due to two important factors: long-standing diabetes with poor control and the absence of your spleen.

The spleen plays a crucial role in clearing bacteria like pneumococcus from the bloodstream, so after a splenectomy, such infections can become more aggressive and progress quickly. This explains the high fever, confusion, and the need for hospitalization.

While there is a risk of recurrence, it can be significantly reduced with the right steps. The vaccination plan your doctors have advised, which includes PCV15 followed by PPSV23, is exactly what is recommended for individuals with your profile.

Once this vaccination series is completed properly, it provides strong protection against most serious strains of pneumococcus. It is unfortunate that you weren’t advised about this earlier, but implementing this plan moving forward will make a meaningful difference.

Your current fatigue and mild cough are expected after such an illness. Recovery from pneumonia, especially one that required hospitalization, can take several weeks.

Patients often experience low energy and a lingering cough for some time, but gradual improvement is a key sign of recovery. If your symptoms worsen or if a fever returns, it will require reassessment.

For long-term prevention, the most important step is maintaining strict control of your diabetes, as high blood sugar levels can weaken your immune defenses. Any future fever should be taken seriously and evaluated early rather than waiting, since infections can progress more quickly in individuals without a spleen.

Staying updated with vaccinations, maintaining good hygiene, and not delaying care are essential lifelong precautions. Together, these measures typically help keep patients stable and prevent recurrence.

I hope I have addressed all of your queries and concerns. Please feel free to follow up whenever needed.

Thank you.