Practice Recommendations for Pneumonia and Influenza Vaccines

This report analyzes practice recommendations for pneumococcal and influenza vaccines, focusing on their effectiveness in older adults. It examines the use of pneumococcal vaccines as a preventive measure against pneumonia, highlighting the benefits of PCV7 and PCV13 vaccines and the recommendations from the CDC. The report also reviews the impact of influenza vaccines, the mode of action of the vaccine, and the effectiveness of the influenza vaccine, referencing studies that explore the vaccine's efficacy and cost-effectiveness. It includes a review of peer-reviewed literature, randomized control trials, and observational studies. The report provides an overview of vaccine effectiveness in preventing influenza-like illnesses and hospitalizations, as well as factors influencing vaccine effectiveness and potential biases. References are provided to support the findings and recommendations.

Running head: PRACTICE RECOMMENDATIONS
PRACTICE RECOMMENDATIONS
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Author’s note

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Description of the practice recommendation 1
Pneumococcal vaccines can be considered as a preventive measure for dealing with
pneumonia in older adults. According to Assaad et al., (2012) vaccination is a primary
preventive strategy for the elders suffering against Streptococcus pneumonia and other influenza
infections. The efficiency of the pneumococcal vaccine has not been established firmly due to
the lack of the randomized control trials involving the patients greater than 65 years of age.
According to Assad et al., (2012) vaccination is a primary preventive strategy for the elders
suffering against Streptococcus pneumonia and other influenza infections. The efficiency of the
pneumococcal vaccine has not been established firmly due to the lack of the randomized control
trials involving the patients greater than 65 years of age. Studies have shown that PCV7 has been
highly effective in preventing the invasive pneumococcal disease in the older adults. In 2010,
FDA has given license to PCV 13, which can provide protection against infections caused by 6
more serotypes than the PCV7. CDC has recommended pneumococcal vaccines for all the adults
who are 65 years older or more.
Strength of recommendation with integration of GRADE criteria
Type of evidence- Review

2PRACTICE RECOMMENDATIONS
Increased grade- As it bears a strong evidence of association with a relative risk of >5(<0.2)
based on evidence.
The strength of this study is that it provides a wide view of the outcomes of the acute
disease with which the physicians have to deal with. The paper gives information regarding the
recent recommendations of the advisory committee on the Immunization practice for people
above 65 years age. It can also be known about the various antibody responses occurring
following the vaccination. The paper also reveals the fact that effectiveness of the PPSV23 in
mitigating the symptoms of pneumonia is controversial. Several studies have showed that
PPSV23 have brought about the reduction of the deaths among the older adults.
The strength of this study is that it provides the rationale for taking up pneumococcal vaccine by
the older adults.
Recommendation 2
The peer reviewed literature will help to provide information regarding the effect of the
influenza virus, the mode of action of the vaccine, the portals of entry of the virus and different
evidences supporting the effectiveness of the influenza vaccine. Seasonal or pandemic influenza
are often complicated by the bacterial infection. Influenza A virus is one of the most common
pathogen that is responsible for causing respiratory illness in older adults. According to Lang ET
AL.,(2012), According to the author the influenza vaccine are effective and can act as cost
effective for the elderly population. The paper describes about a randomized control trial that has
been done involving a group of healthy volunteers over the age of 60 and they were randomly
assigned for getting a placebo or an influenza vaccine that is trivalent inactivated.

3PRACTICE RECOMMENDATIONS
The paper aimed at identifying all the meta-analysis that can estimate the effectiveness of the
influenza vaccine. All the literatures have been searched by electronic databases like PUBMED,
MEDLINE.
Strength of recommendation with integration of GRADE criteria
Types of evidence- Peer reviewed journal
Overall quality of the evidence- Moderate.
Study design- peer reviewed literature on randomized control trials ad observational
studies.
The strength of this recommendation is that provides an estimate of the effectiveness of
the influenza vaccine. According to this paper, a randomized control trial could actually found
out that the effectiveness of the influenza vaccine in a mixed hospital and a community has been
41% and 58% respectively. The effectiveness of the influenza vaccine for the influenza like
illness was found to be 23% (with 95% confidence interval). The paper provides an insight to the
fact that influenza vaccine has been found to prevent hospitalization of the older adults in almost
49 % of the cases. The strength of this paper is that it provides information of the different
factors that actually helps in measuring the effectiveness of the vaccine. The paper has also
referred to the biases that can be partially or completely responsible for the data against the
effectiveness of the influenza vaccine. The rising deaths and the increased rates of hospitalization
due to influenza, in spite of the trivalent influenza virus vaccine raise the question on the
development of the vaccine. Yet, the evidences provided by this paper indicate towards the

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future implication of the vaccine in this field. The information in this paper provides the rationale
for choosing this paper for the topic.

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References
Assaad, U., El-Masri, I., Porhomayon, J., & El-Solh, A. A. (2012). Pneumonia immunization in
older adults: review of vaccine effectiveness and strategies. Clinical Interventions in
Aging, 7, 453–461. http://doi.org/10.2147/CIA.S29675
Lang, P.-O., Mendes, A., Socquet, J., Assir, N., Govind, S., & Aspinall, R. (2012). Effectiveness
of influenza vaccine in aging and older adults: comprehensive analysis of the evidence.
Clinical Interventions in Aging, 7, 55–64. http://doi.org/10.2147/CIA.S25215