Friday, May 2, 2014

Vaccines: Pc

Pc or Pneumococcus is the second installment in my series of posts on vaccines. To read my post on HIB, and why I started this series, click here. 
All information from Dr. Sears' The Vaccine Book.

Pc: Pneumococcus
>Given at 2, 4, 6 and 15 months of age. 

Pc bacteria, or Streptococcus pneumoniae, is a bacterium that, like the HIB bacterium, is passed like the common cold and is more common in infants, toddlers and the elderly. The Pc bacteria can cause:
          Cold symptoms
          Ear Infections
          Blood Infections
          Meningitis- an infection of the lining of the brain
          Pneumonia- an infection causing fluid to build up in the lungs

Signs and symptoms of infection with Pc:
Mild infections caused by Pc present like a cold. A fever that does not resolve on it's own after a few days would prompt a trip to the pediatrician, who would treat with antibiotics if symptoms of ear or sinus infection, bronchitis or possible pneumonia are present. Usually the antibiotics will treat the illness without ever being discovered as Pc. 
Moderate infections begin like a mild infection does, but the child will also appear lethargic, may have labored breathing and will "look sick" enough to call for a chest X-ray, blood work and oral antibiotics or IM antibiotics (administered my intramuscular injection).  The blood cultures are positive for Pc (that take 48 hours to result), and the parents of the child will be called to have the child come to the hospital for 1-2 weeks of IV antibiotics.
Severe infections with Pc will present with meningitis or blood infection symptoms which the treating doctor will immediately recognize. The child would be immediately admitted to the hospital for several days of aggressive IV antibiotics and possibly respiratory support via endotracheal intubation in an intensive care unit. Most children with severe Pc infection will recover fully but it may take weeks in the hospital. Long lasting complications such as brain damage or hearing loss are caused by swelling of the brain. Fatality is 20-30%, 60-80% in the elderly. 

~Pc is the most common cause of meningitis in infants and a common cause of respiratory infections. Infection with Pc is not required to be reported to the CDC, so it is difficult to say precisely how common it is. It is believed that the number of serious Pc infections has decreased from 60,000 cases yearly to 17,000 cases after vaccination began in 2001. 
   Although the vaccine has done much good, the current vaccine now only covers 2% of the known strains of Pc. A newer version of the vaccine, Prevnar 13, was formulated to cover a new strain, 19A, which was resistant to some antibiotics. As the vaccine is reformulated and distributed, new strains crop up and older ones die out, so Pc will never be completely eradicated. 

~The Pc vaccine is made by using the sugars that coat the outside of the bacteria and are added to the vaccine solution along with diphtheria toxoid pieces and aluminum. The vaccine does not contain full or living Pc bacteria, so there is no chance of infection by Pc from the vaccine. 

Potentially Harmful Ingredients
  • The Prevnar 13 contains 125 micrograms of aluminum. Toxic effects of aluminum can occur if too many aluminum containing vaccines are given at one time. In the book, Dr. Sears includes an alternate vaccine schedule which you can find here, on another page of this blog that I copied out of the book. 
Common Side Effects

  • Local redness, swelling and pain at injection site (50% of kids), 80% of kids report fussiness or irritability, moderate to high fever (5%). Severe reactions are reported in 8% of test infants. Severe allergic reactions or seizure occurred in less than 1%. Post market surveillance reveals that the vaccine can also cause rash at injection site, lymph node swelling in the injected limb, anaphylactic shock, angioneurotic edema (severe swelling) and apnea (a period of not breathing). 

Dr. Sears' Summary: "Pc infections can be very bad or only minor irritations. The problem is, you don't know until you're stuck with one. The Pc germ is a fairly common resident in day cares, schools, and check out lines at the grocery store. Unless you are a housebound agoraphobic or a stay at home mom who never, ever takes her baby out, you and your kids will encounter the germ. The Pc vaccine offers a "get out of jail free" card, so to speak. Overall, I'd call this a fairly important vaccine."

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