Wellness Matters

Prevention is Key: What's New on the Vaccine Scene

January 18, 2016

Deborah Schoenhoff, MD, NCMO
Women's Health Network, MedCenter High Point

Dr. Deb
As a doctor, I treat people when they are sick. But I would much rather help you to stay well. Vaccines are an easy way of doing that. There are two recent vaccines I’d like for you to consider. One helps to prevent pneumonia and its complications, and the second prevents many types of cancers and genital warts in both women and men.

Pneumonia and the Prevnar 13 Vaccine

For many years, we have used a vaccine (brand name Pneumovax or Pnu-Imune 23) to protect people over the age of 65, and those younger with high-risk conditions, against pneumonia and its invasive complications. This lung infection is caused by the Streptococcus pneumoniae bacteria of which more than 90 types have been identified. One vaccine doesn’t protect against all 90 types; however, Pneumovax or Pnu-Imune 23 covers the 23 types that are associated with very serious illness.

The new Prevnar 13 vaccine offers protection against 13 more bacteria types. In healthy adults, the pneumonia vaccine should be given in a dual schedule, waiting one year between receiving either vaccine. If you are younger, there are certain high-risk conditions that qualify for earlier vaccination. Some of these conditions include but are not limited to sickle cell anemia; diabetes; cancer or its treatment; smoking; and chronic heart, lung, liver or kidney disease. Revaccination (one time only) with Pneumovax or Pnu-Imune 23 is recommended after five years. No revaccination is recommended for the Prevnar 13 vaccine.

Human Papillomavirus (HPV) and the Gardasil 9 Vaccine

HPV is a sexually transmitted virus that is associated with genital warts and certain types of cancers in both women and men. Some types of this virus cause persistent infections that are associated with virtually all precancers and cancers of the cervix, several types of cancers in the vagina and outer vagina (vulva) in women, and most types of anal cancer in both women and men. Persistent HPV infection has also been linked to cancers of the mouth and throat, and it is unfortunate that new cases of these oral and throat cancers have been rising in the United States. Currently, there are three different vaccines that vary in the number of HPV types they protect against. The newest goes by the brand name Gardasil 9 and gives the greatest coverage, protecting against nine virus subtypes. All vaccines are given in a three-vaccine series.

Most physicians strongly encourage vaccinating both males and females at age 11 or 12. However, this vaccine can be started as early as age 9 and as late as age 26. It is most effective when the vaccine series has been completed before the first sexual encounter. Vaccination of both males and females will prevent further transmission via sexual encounters. The Advisory Committee on Immunization Practices recommends Gardasil 9 as the first choice because it gives the greatest protection. For now, giving the Gardasil 9 vaccine to those who have already completed the three-dose series with another type of HPV vaccine is not warranted. It is very important to remember that all women should still have cervical Pap screenings beginning at age 21 even if they have been vaccinated. High-risk individuals who have immune-compromising conditions and/or HIV should also get vaccinated.

Vaccination is perhaps one of the easiest and most effective ways to prevent not only contagious illnesses, but certain cancers as well. (Speaking of vaccinations, have you had your flu shot? It’s not too late.) New pneumonia and HPV vaccines are exciting developments. Talk with your health care provider about them. As always, my staff and I at the Women’s Health Network will be happy to assist you with any vaccine-related questions. For more information, please visit www.cdc.gov, www.uptodate.com or www.conehealth.com.

This article first appeared in the December 2015 edition of Guilford Women magazine. 

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