When you think about winterizing your vehicle this winter, consider protecting yourself as well. Being cooped up inside more during the winter months puts us at risk for many respiratory illnesses, and disease caused by the bacteria Streptococcus pneumoniae (or pneumococcus) is a specific threat. This bacteria causes thousands of deaths each year in the U.S., with about 18,000 over age 65. In addition, many more end up in the hospital with serious illnesses including pneumonia (lung infection) and meningitis (infection of the covering of the brain and spinal cord).
Pneumonia severity can range from a fairly mild viral form (hence the layman’s term “walking pneumonia”) to a life-threatening version caused by multiple bacteria. Pneumococcus can cause sinusitis or ear infections, but once in the body, the bacteria can spread and cause pneumonia or even meningitis. Like other infectious diseases, those with compromised immune systems are at increased risks, and these include the young and the elderly.
What’s new? Have you heard there’s a vaccine for pneumonia? It turns out that there are now two different vaccines that help protect against pneumococcal disease, and these have different recommendations. As usual, here are some more acronyms — PPSV23 (also called Pneumovax23) is Pneumococcal Polysaccharide Vaccine (directed against 23 strains of the bacteria) and PCV13 is Pneumococcal Conjugate Vaccine (directed against 13 strains). These vaccines are made differently, and although there is some overlap, each is effective against some strains that are not covered by the other vaccine. Thus to be maximally protected, one needs to get both vaccines.
Both vaccines are recommended for adults age 65 and older, both are recommended for 19 and over with certain health conditions or who are smokers (PPSV23 specifically for smokers), and both are recommended for age 19 and older who have weak immune systems due to disease or medications. If you’re over age 65, both vaccines are recommended, but you cannot get both vaccines at the same time. PCV13 is recommended first, followed by PPSV23 12 months later. However, you can get either of the pneumonia shots and a flu shot at the same time. The good news is that booster shots are not needed — once is enough!
Children should also be protected against pneumococcal disease. In children, pneumococcal bacteria cause ear infections in addition to pneumonia and meningitis, and studies have shown that pneumococcal vaccination helps protect against ear infections and reduces the need for tubes in the ears. PCV13 is now part of the recommended routine immunization schedule for those 2, 4, 6, and 12-15 months of age. Children 2–5 years should get a dose of PCV13 if they were never vaccinated or didn’t complete the series during their first 2 years of age or have one of several chronic conditions. Older children age 6-18 should also get a dose of PCV13 if they have certain health conditions or didn’t finish a PCV13 series when younger.
Pneumococcus is serious business, folks. You can read one family’s story of almost losing their twin boys to pneumonia at Please visit your primary care provider and discuss how you can winterize your family this winter — and longer!

Dr. Fleming is the Medical Director of The Jane Pauley Community Health Center (, a Federally Qualified Health Center (FQHC) with offices in Indianapolis, Anderson, Greenfield, and Shelbyville. Ideas for this column can be e-mailed to Dr. Fleming at Or you can write your medical questions to Dr. Fleming at AskDrFleming, 5317 E. 16th Street, Indianapolis, IN 46218. On written correspondence, please include your name and city (names will not be published).