Vaccine for Smokers

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http://news./s/ap/20081023/ap_on_he_me/med_vaccine_for_smoker

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Panel calls for vaccine for adult smokers

ATLANTA – For the first time, an influential government panel is

recommending a vaccination specifically for smokers. The panel

decided Wednesday that adult smokers under 65 should get pneumococcal

vaccine. The shot — already recommended for anyone 65 or older —

protects against bacteria that cause pneumonia, meningitis and other

illnesses.

Federal officials usually adopt recommendations made by the panel,

the Advisory Committee on Immunization Practices. The vote means more

than 31 million adult smokers probably will soon be called on to get

the shot.

Studies have shown that smokers are about four times more likely than

nonsmokers to suffer pneumococcal disease. Also, the more cigarettes

someone smokes each day, the higher the odds they'll develop the

illnesses.

Why smokers are more susceptible is not known for sure, but some

scientists believe it has to do with smoking-caused damage that

allows the bacteria to more easily attach to the lungs and windpipe,

said Dr. Pekka Nuorti, a medical epidemiologist with the Centers for

Disease Control and Prevention.

Pneumococcal infections are considered the top killer among vaccine-

preventable diseases. It's a common complication of influenza,

especially in the elderly, and is considered responsible for many of

the 36,000 annual deaths attributed to flu.

The committee voted 11 to 3 to pass the recommendation, with one

member abstaining. The panel also added a call for smoking cessation

counseling.

Some members said it might be more cost effective to recommend the

vaccine for smokers who were at least age 40, because pneumococcal

disease is relatively uncommon in younger smokers. Others at the

meeting made the same argument.

Dr. , who oversees student health programs at the

University of Virginia, said about one in five college students smoke

but he has never seen a case of serious pneumococcal disease in a

student body.

" I wonder how many young people are truly benefiting from this "

recommendation, said , speaking as a representative of the

American College Health Association.

The shot is less than perfect. First licensed in 1983, it is designed

to protect against 23 strains of pneumococcal bacteria. But it hasn't

proved very effective against pneumonia, and hasn't been very

effective in warding off other pneumococcal illnesses in people with

weakened immune systems and people age 80 or older.

It's to be given to smokers as a one-time dose with no booster, but

its protection drops off after five to 10 years.

Made by Merck & Co., it's sold under the trade name Pneumovax and

costs about $30 a dose.

A different vaccine — Wyeth's Prevnar, which came on the market in

2000 — is recommended for children under age 2, and for kids 2 to 5

with certain chronic conditions or who are at higher risk for

illness. That vaccine costs about $84 per dose.

Prevnar protects against seven strains of bacteria that were the most

common causes of pneumococcal diseases at the time the vaccine was

developed. But lately, those strains have stopped being important

causes of illness. Experts have become concerned about dozens of

other strains, including some that have flourished and become

resistant to antibiotics.

Wyeth has been developing a new vaccine. It is expected to present

study data on it at a scientific meeting later this month, and to

apply for government licensing approval early next year.

Also on Wednesday, the committee for the first time voted on

recommendations about whether anthrax vaccine should be given to

children and pregnant women in the event of a terrorist incident.

The committee noted that the vaccine, made by Emergent BioSolutions,

is not licensed for use children and has not been studied in

pediatric patients. But post-exposure vaccination in children may be

considered, depending on the circumstances, the members concluded.

The committee also decided that pregnant women should receive vaccine

if they are exposed to inhalation anthrax. They heard the results of

a recent study of more than 37,000 infants born to vaccinated

military women in 1998 through 2004. It found no increase in birth

defects when mothers were vaccinated before they got pregnant or

vaccinated late in pregnancy. A small increase in birth defects was

reported for women vaccinated during the first-trimester, but it

wasn't clear the vaccination caused the problems, CDC officials said.

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On the Net:

CDC: http://www.cdc.gov/vaccines