Pneumonia vaccines proven effective

Dear Dr. Roach: Whenever I go to my local VA clinic for a checkup, I’m asked if I want the pneumonia vaccine. I’m 70, and I wonder if that vaccine has proven to be beneficial. Thank you.

L.B.

Answer:

There are two pneumonia vaccines. One is the 23-valent pneumococcal polysaccharide vaccine, often called by its brand name, Pneumovax. The evidence that it is beneficial is strong. It reduced the most serious type of invasive disease (such as meningitis) by 75% and of less serious disease (such as pneumonia) by more than 50%.

The second type of pneumonia vaccine is the 13-valent pneumococcal conjugate vaccine, Prevnar. It is also effective, and against some different strains from those covered by the 23-valent vaccine. It was also shown to reduce infections caused by the bacteria Streptococcus pneumoniae by 50% to 75%.

If you plan to get both vaccines, get the PCV13 first, followed by the PPSV23.

Dear Dr. Roach:

I’m 63 and in great health and shape. I work out daily, be it weights, running, hiking or cycling. I’m 5 feet, 10 inches tall and weigh 165 pounds. I have terrible balance. Added to that, I have postural hypotension. Combine the two and a fall seems to be destined in my very near future. Advice?

M.T.

Answer: It’s great that you are in such good shape, but a fall can be a devastating event for even a healthy person in their 60s.

From a balance standpoint, I recommend you add in specific balance exercises. Although balance is certainly needed for the activities you do, an activity like tai chi has been proven to reduce the risk of falls.

Postural hypotension is when the blood pressure goes down upon change of position. General advice includes taking extra time after changing positions to allow your body to get used to the new positio. Also, make sure you are getting enough fluids. Some people with symptomatic postural hypotension need extra salt, but I can’t give that advice without knowing a lot more about you.