Patient Information: Pneumococcal Vaccines

What is Pneumococcal disease?

Pneumococcal disease is any infection caused by Streptococcus pneumoniae that can lead to life-threatening diseases such as pneumonia (infection in the lungs), septicemia (infection of the blood) and meningitis (infection of the lining of the brain).

What vaccines are available?

Currently, there are 2 pneumococcal vaccines – Prevnar-13 and Pneumovax-23.

How are the two vaccines different?

Both vaccines are given to prevent pneumococcal infections. Prevnar-13 protects again 13 types of pneumococcal bacteria including 1 strain not in Pneumovax-23, and Pneumovax-23 prevents infection from 23 strains, including 11 that aren’t in Prevnar-13.

When do I get Prevnar-13? Is there a cost?

Prevnar-13 is given to babies at 0, 4 and 12 months of age as part of routine immunization. Prevnar-13 is also recommended for anyone 5 years of age and older at high risk of pneumococcal disease. This vaccine is provided free as part of the infant immunization program and to children and adults with certain medical conditions.  

When do I get Pneumovax-23? Is there a cost?

Pneumovax-23 is recommended for adults  > 50 years of age, residents of any age living in long-term care or assisted living facilities, and anyone 2 years of age and older with certain medical conditions. This vaccine is provided free to any adult > 65 years of age, residents of any age living in long-term care or assisted living facilities, and anyone 2 years of age and older with certain medical conditions.

Should I get need both vaccines?

Getting vaccinated against both vaccines is expected to prevent more pneumococcal infections.

What if I received Prevnar-13 already?

Pneumovax may be administered at least 8 weeks after receiving Prevnar-13.

What if I received Pneumovax-23 already?

Prevnar-13 may be administered at least 1 year after receiving Pneumovax.

How many doses do I need?

The usual adult dose for Prevnar-13 is a single dose. The usual adult dose for Pneumovax-23 is also a single dose but a booster may be required in some situations.

What are the side effects?

The most common side effects of these vaccines include some redness, swelling, pain, and soreness at the injection site. They are usually mild and go away within a few days. Some people may not experience these side effects at all.

Do I need a prescription? Can I get my vaccination at BioPro Biologics Pharmacy?

No prescription is required. Injection Certified Pharmacists in British Columbia can administer any vaccine without a prescription to any individual at least 5 years of age.  Talk to an Injection Certified Pharmacist at BioPro Biologics Pharmacy for more information.

References:

  1. CPS [Internet]. Ottawa (ON): Canadian Pharmacists Association; c2016 [updated 2016 04 15; cited 2018 08 10]. Pneumovax 23 [product monograph]. Available from: http://www.e-cps.ca or http://www.myrxtx.ca. Also available in paper copy from the publisher.
  2. Prevnar 13. In: Lexi-Drugs Online [database on the Internet]. Hudson (OH): Lexcomp, Inc; 2016 [updated 2018 07 17; 2018 08 10]. Available from : http://online.lexi.com.
  3. CTC [Internet]. Ottawa (ON): Canadian Pharmacists Association; c2016 [updated 2018 03; cited 2018 08 10]. Community-Acquired Pneumonia. Available from: https://www.myrxtx.ca. Also available in paper copy from the publisher.
  4. https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-16-pneumococcal-vaccine.html
  5. https://www.healthlinkbc.ca/healthlinkbc-files/pcv-13-vaccine
  6. https://www.healthlinkbc.ca/healthlinkbc-files/pneumococcal-polysaccharide-vaccine
  7. http://travelclinic.vch.ca/news/pneumo/
  8. https://www.prevnar.ca/EN/adult#safety-information

Rheumatoid Arthritis: Tips to better manage your symptoms

Living with Rheumatoid Arthritis can be difficult for you and your family. At BioPro Biologics Pharmacy, we have Primary Care Pharmacists working in a multidisciplinary practice who can help you better manage this disease and answer any questions you may have. Here are some tips to help you better manage Rheumatoid Arthritis:

  1. Recognize flare-ups and know when to seek medical advice

Early recognition of worsening symptoms is very important in the management of Rheumatoid Arthritis. If you have a flare-up, see your doctor as soon as you can so that it is appropriately treated and followed up on. Early intervention can reduce disease progression and prevent joint deformities.

  1. Adherence to your prescription medications

Rheumatoid Arthritis, if not treated promptly, can become a very debilitating disease. Prescription medications slow disease progression and prevent joint deformities. Remember to take your medications consistently to get your arthritis under control and/or to prevent flare-ups. If you have concerns about your medications, their side effects, and/or their risk/benefit profile, feel free to book an appointment with a BioPro Primary Care Pharmacist for a consultation.

  1. A balance of rest and exercise

Stay active! There are multiple health benefits associated with regular physical activity such as preventing cardiovascular disease, increasing overall mood, and improving bone and joint strength. But remember not to overdo it! See an Advanced Practice Physiotherapist at our health centre if you have questions about which exercises and activities are appropriate for you.

  1. Avoid smoking

Smoking is associated with a more severe form of Rheumatoid Arthritis and may reduce the effectiveness of some Rheumatoid Arthritis medications. If you are interested in quitting smoking, talk to one of our Primary Care Pharmacists to review available options, including government-funded ones. BC residents are eligible for coverage of up to 3 months of smoking cessation products!

  1. Use of assistive devices

Protect your joints and minimize fatigue! Splints, braces, canes and special kitchen tools      can reduce pain, prevent deformity, as well as stabilize and reduce stress on the joints. Consider seeing an Occupational Therapist – they can develop a program to increase your mobility and functionality. Stop by BioPro Biologics Pharmacy for a selection of special assistive devices!


References:

https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/rheumatoid-arthritis#12

https://www.nice.org.uk/guidance/ng100/chapter/Recommendations#non-pharmacological-management

https://www.arthritis.ca/about-arthritis/arthritis-types-(a-z)/types/rheumatoid-arthritis

https://www.healthlinkbc.ca/health-topics/hw86269

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4284707/

https://rheumatoidarthritis.net/exercise/

Health Professional Newsletter: The Data on Herpes Zoster Vaccines

table

Shingrix vs Zostavax

  • Shingrix – available 2018
    • Inactivated vaccine
    • 2 doses separated by 2-6 months
    • improved efficacy
    • maintained efficacy in age 70+
  • Zostavax
    • live attenuated vaccine
    • single dose

Evidence supports the vaccination of both immunocompetent and some immunocompromised individuals to reduce the risk of an acute shingles infection.


The Data

Zostavax – the efficacy is often quoted as 50%; when looking at the evidence, this translates into a NNT of 59 for shingles prevention and 364 for post-herpetic neuralgia prevention. Also, it has been noted that with increasing age the Zostavax may have lower efficacy, in particular for patients over 70.

Shingrix – The advertised efficacy for this vaccine is 97%. The data from the trials illustrates a NNT of 37 for shingles prevention, and 335 for post-herpetic neuralgia prevention. Although there is a reduction in the NNT, it is not nearly as impressive as the 97% that is being advertised. However, Shingrix does appear to maintain efficacy in the older patient cohorts.

The actual duration of coverage is a question left unanswered for both vaccines, as Zostavax has a confirmed efficacy up to 4 years, and Shingrix has similarly been studied for around 4 years.

Contact us if you have further questions about the herpes zoster vaccines.

July 19th Lunch Discussion: Medical Cannabis

How are patients currently accessing cannabis? How is this going to change with its legalization? What do healthcare providers need to know about medical cannabis? Visit BioPro Biologics Pharmacy (845 W Broadway, Vancouver) for a lunch discussion from 12-1pm on Thursday, July 19th to learn about access and options for medical cannabis presented by one of our clinical pharmacists, Kevin Wang. Lunch and beverages will be provided.

Please RSVP at info@biopropharmacy.ca or fax 778-379-8160.event timeline - osteoarthritis management - clinic presentation-1