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#pneumococcal

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Public
Lkdc

I'm a great believer in vaccines, but am not always certain which ones I need. Pre-pandemic, I found a CDC chart indicating that people of my age group needed several vaccines, but a pharmacist told me that I should get only a flu shot. He told me I didn't need a tetanus shot every 10 years, as recommended by the CDC. Now, the situation is even more confusing. News reports say that pneumococcal shots are now recommended for people my age, but the CDC's latest chart doesn't indicate that. The chart does, however, recommend Tdap and hepatitis shots, which no doctor has suggested that I get. I don't want to act like I know better than my doctors, but I'm concerned that I may be missing important care.

I would appreciate thoughts on whether I should try to obtain the following, and whether typical US health insurance would cover them:

* Tdap (last shot was decades ago)

* Hepatitis (never vaccinated)

* Pneumococcal (never vaccinated)

#vaccines#Tdap#pertussis
Public
Vivek Mutalik

#Pneumococcal #capsule expression is controlled through a conserved, distal cis-regulatory element during infection | PLOS #Pathogens

journals.plos.org/plospathogen

journals.plos.orgPneumococcal capsule expression is controlled through a conserved, distal cis-regulatory element during infectionAuthor summary Streptococcus pneumoniae (the pneumococcus) is a Gram-positive pathogen that causes significant morbidity and mortality in the US and worldwide. The pneumococcus first colonizes the upper respiratory tract asymptomatically, and then drops into the lung to cause pneumonia, followed by sepsis (blood infection), where patient mortality rates exceed 20%. Studies have indicated that the reason S. pneumoniae can survive in the blood so well is due to its protective polysaccharide capsule. This vital virulence factor acts as a sugary coat which shields the bacterium from immune detection, opsonization, and phagocytosis. However, how this metabolically expensive virulence factor is regulated during colonization, lung infection, and sepsis has remained enigmatic. Here we describe two transcription factors, SpxR and CpsR, which repress capsule biosynthesis in the airways through a small, conserved, regulatory piece of DNA (the 37-CE) until the onset of sepsis–where repression is relieved, allowing for increased capsule biosynthesis, and by association, the high mortality associated with this condition. The 37-CE varies considerably among the 100+ pneumococcal serotypes, each of which has a chemically-distinct capsule composition. This may, in part, explain the variation in serotype-dependent disease severity we have observed for decades.
Public
Simon Wheeler

Interested to hear from anyone who knows about prevention of disease in older people (including those with ).
Is the newer 20-valent worth supporting greater access to?
I've seen a US report from January which seemed to suggest they were good value and more effective than currently used 13-valent ones.

Should the UK be using these to prevent outbreaks in care homes?

cdc.gov/mmwr/volumes/71/wr/mm7

Centers for Disease Control and PreventionUse of 15-Valent Pneumococcal Conjugate Vaccine and 20-Valent ...By CDC
#pneumonia#infection#respiratory
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