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 of 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 key role in clearing bacteria such as pneumococcus from the bloodstream, so once it's removed, these kinds of infections can become more aggressive and move much more quickly. That's what explains the high fever, the confusion, and why hospital treatment was needed. There is a risk of it happening again, but the good news is that this risk can be significantly reduced with the right steps. The vaccination plan your doctors have recommended, PCV15 followed by PPSV23, is exactly what's advised for someone in your situation.

Once the full vaccine series is complete, it gives you strong protection against most of the serious pneumococcal strains. It's disappointing that this wasn't brought up with you earlier, but starting the plan now will still make a real difference from here on, and that's the important thing.

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, you 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.

Keeping your vaccinations up to date, practicing good hygiene, and never putting off care when you need it are all important lifelong precautions. Together, these steps usually go a long way in keeping patients stable and preventing the infection from coming back.

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

Thank you.