Jama February 17, 2015 and important updates on Lung Cancer screening and Pneumonia Vaccines (Pneumovax)

In this issue of Jama, 2 important issues are reviewed. More evidence is mounting that there is benefit to screening specific high risk individuals for Lung Cancer. However, screening to save comes at a cost of harm of over diagnosis and incidental findings the further evaluation of which can cause potential trouble. The main emphasis of the article is that screening should be individualized taking risks and benefits into account.

With respect to pneumonia vaccines, there are now 2 that are available for prevention of “invasive disease” (not all pneumonia) in adults caused by a bacteria called Streptococcus pneumoniae. They are PCV13 and PPSV23. My take on the ACIP summary are as follows:
1. Those >= age 65 without any prior pneumonia vaccines should get PCV13 followed by PPSV 23 6-12 months later.

2. Those >= age 65 with prior PPSV23 vaccination at > 65 should receive PCV13 >= 1 year after the initial vaccination (“the 1 year boost”)

3.  Those >= age 65 with prior PPSV23 vaccination at < age 65 should receive PCV13 followed be PPSV23 6-12 months later but both 5 years after the initial vaccination (“the 5 year boost”)

Pneumovax Abstract Link

Lung Ca Abstract Link


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