According to a new federal proposal, a combination of pneumococcal 13 valent conjugate vaccine and the 23 valent polysaccharide vaccine will provide the most complete protection for patients over 65 years of age.
For those who have never been vaccinated, the preferred sequence would be the PCV13 first, followed by the PPSV23 within a period of 6 to12 months. Additionally, those who already received the 23 valent (which is now what is being administered to 65 years and older) can receive the 13 valent at least one year later. Although the clinical recommendation was made by the Centers for Disease Control and Prevention, the federal body controlling reimbursement has NOT passed policies to facilitate implementation. At this time, Medicare pays for only ONE pneumococcal pneumonia vaccine for adults aged 65 years and older. However, if this dual-vaccination practice is adopted by the Centers for Disease Control, the Centers for Medicaid and Medicare must consider adopting the change in due time.
The PCV13, when added to the current PPSV23, offered significant protection against pneumonia with 45 percent fewer first episodes of non-bacteria pneumonia and 75 percent fewer episodes of invasive pneumonia.
The Big Point: the addition of the vaccine creates a good safety profile, and the cost benefit analysis makes this a cost-effective and efficient preventative approach.
Typically decisions in coverage through the Centers of Medicaid and Medicare wouldn’t go into effect until January. Please check with your insurance carrier regarding coverage.
Is it time for your vaccination? Please call our office today at (757) 488-3333 to schedule your appointment.
Always keeping our patients informed,
~Dr. Samir Abdelshaheed and the Family Medicine Healthcare Team