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To whoever mentioned the pneumonia vaccine...

by J. Vega / September 14, 2004 2:58 PM PDT

I don't remember who bought up the fact that there was a pneumonia vaccine (I just never thought to look to see if there was one) but thanks.
Somebody bought me over to my doctor's ofice today, and he was (as normal) going to have the nurse give me an injection of B vitamins (the only way that I can get them).
As I was showing him pictures that I printed with my computer, computers were in the back of my mind and I suddenly remembered that post. I mentioned to the doctor that it might be a good idea for him to order me a dose, as I'm pretty sure that I had pneumonia last winter. It turns out that he had it on hand already and the nurse gave me a dose, so now I'm protected.
Bottom line, if you hadn't made that post I wouldn't have remembered it and now be protected. So thanks again, your happening to have mentioed that vaccine being avalible resulted in my being protected from a quite possible "nasty situation" this winter.

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Re: To whoever mentioned the pneumonia vaccine...
by David Evans / September 14, 2004 3:05 PM PDT

Hey, Dr. DE mentioned that once! I'm glad you got it. I'm a big believer in those vaccines.

DE

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Then no doubt about it...
by J. Vega / September 14, 2004 3:43 PM PDT

Then no doubt about it, I owe you one. If we ever meet after I change my location, the drinks are on me.
BTW, my doctor made a deal with me about going to the hospital. If something specific comes up and I call 911, the ER will automatically admit me, give me what I say that I need, and not "handcuff" me to an IV pump. Then, the next day he'll come over and we can calmly discuss what will be done. This deal I can live with, so I promised.

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(NT) (NT) Dear J: Glad you found 2 more aces up your sleeve!
by Mosonnow / September 14, 2004 6:35 PM PDT
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(NT) (NT) j did u say moveing to the atl area?
by Mark5019 / September 14, 2004 6:57 PM PDT
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Yes, Mark...
by J. Vega / September 15, 2004 4:59 AM PDT

Yes, Mark, I intend to be down there before the cold weather hits.

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(NT) (NT) k i thought you said that
by Mark5019 / September 15, 2004 5:01 AM PDT
In reply to: Yes, Mark...
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Re: To whoever mentioned the pneumonia vaccine...
by Angeline Booher / September 14, 2004 11:33 PM PDT

Kudos to DavE!

I am grateful that Medicare will pay for a pneumonia shot - in my case, every 6 years. Had one last fall.

One caution, J. I am only mentioning this because I wouldn't want you to think if you get sick at a later date, "It can't be pneumonia, because I had the shot."
There are several causes for pneumonia.

http://www.alaw.org/lung_disease/influenza_and_pneumonia/

You are now protected from the most common culprit.

Here are some good rules for everyone to follow:

1. hand washing after being out in public, handling money, being around anybody with a "cold", and before eating

2. keeping fingers away from eyes and nose, as bugs enter through them as well as the mouth

Congrats on having a plan for a course of action with your doctor!

Angeline
click here to email semods4@yahoo.com

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I'll be careful, Angeline..
by J. Vega / September 15, 2004 5:05 AM PDT

I'll be careful, Angeline, especially as after I move I'll get out much more than I do now (the screaming understatement of a lifetime) and be able to be with others "real time" and not just on a computer.
Moving will be like Christmas was when I was a litle shaver (grin).

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(NT) (NT) :-)
by Angeline Booher / September 15, 2004 5:51 AM PDT
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Re: To whoever mentioned the pneumonia vaccine...
by Dave Konkel [Moderator] / September 14, 2004 11:40 PM PDT

Hi, J.

Besides DE, JR, Dr. Bill, and I have all mentioned them at one time or another. My father died of pneumonia, and had never gotten the vaccine, which I found baffling. That reminds me that Mark might want to get the vaccine, now that he's had it once; I'm pretty sure having pneumonia once increases the risk (Dr. Bill?) Speaking of Dr. Bill and JR, here's a detailed discussion of the recommendations about who should take the shot and when.

-- Dave K, Speakeasy Moderator
click here to email semods4@yahoo.com

The opinions expressed above are my own,
and do not necessarily reflect those of CNET!

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It's a complicated question ...
by Bill Osler / September 15, 2004 9:48 AM PDT

I haven't seen any data for recurrent pneumonia risk in general. However, if I divide pneumonia patients into 2 groups I can give a partial answer:
(1) Patients who get pneumonia for no particular reason. I have not seen any data regarding their risk of recurrence.
(2) Patients who have risk factors for pneumonia. They are clearly at high risk for recurrence, and they should receive the pneumococcal vaccine.
There is one issue here. I try to remember to immunize pneumonia patients with the pneumococcal vaccine, and my understanding is that most physicians do likewise. However, when I actually read through the list of indications for the vaccine, a personal history of pneumonia is not on any of the lists I've seen. It does not make sense to me.
Also, although I think asthma patients should receive the vaccine, many insurance companies will not pay for the vaccine for asthma patients. It seems to me that asthma should be included in the category of "cardiopulmonary disease" but some folks apparently do not interpret that indication as including asthma. That also does not make sense to me.

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Thje cost around here...
by Angeline Booher / September 16, 2004 1:52 AM PDT

... for the pneumococcal vaccine is $20.

It is ludicrous, IMO, for insurance companies to deny it. The only minutely possible reason I can see is if the patient claims to have an untoward reaction, and chooses to sue everybody in sight, so they want to be out of the line of fire.

Angeline
click here to email semods4@yahoo.com

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Re: Thje cost around here...
by Roger NC / September 16, 2004 9:48 AM PDT

Actually, I can't understand insurance companies tendacy to not pay for preventive measures. In health that means vaccines and some other measures.

In other cases, my sister's homeowner insurance after a hurricane dropped a tree on one in of the house paid that damaged. But it wouldn't pay to remove another tree left leaning at about 30 degrees with the offside roots showing out of the ground. The agent told them they'd pay to rebuild the house if the tree fell on it. The tree was leaning over the center, and would have bisected two childrens bedrooms. Of course the agent knew my sister and BIL would pay to have it took down, so he just avoided payout.

But in general, insurance companies seem to suffer from an incomprehensible attitude to paying a smaller fee to avoid a larger one. They're betting on either the odds it won't happen (tree falling or getting sick) or that the individual will pay out of pocket. That saves them the money of prevention and still saves them the cost of recompensation later.

Sigh, a fair bet if anyone can afford the vaccinations and believes in them. Hard on the low income but insured.

Insurance companies maximizing return, indiscriminate of what it costs others, normal business procedure nowadays it seems.

RogerNC

click here to email semods4@yahoo.com

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I think there is another reason as well ...
by Bill Osler / September 16, 2004 11:28 AM PDT

Insurance companies are also betting that a large number of their customers will have insurance through some other plan by the time the lack of preventive services catches up with them.

It turns out that the real payoff for many preventive services is far enough into the future that it does not reliably enter into the equation for companies that are focused on short term performance.

It's a shame.

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I'm with you, Roger...
by J. Vega / September 16, 2004 5:29 PM PDT

Roger, although my health care plans are government, I'm with you. When I asked for a wheelchair I was refused. The same for when I asked for a hospital bed for my room. I wanted them for preventive measures, in every sense of the word, as I felt that I had a great risk of falling down and injuring myself.
Needless to say, refusal of the chair cost me shatered hip #1 and not too long after that refusal of the bed cost me shattered hip #2 (happened trying to get out of a regular bed and into the chair which they finally gave me after the hip #1).
Bottom line and how it relates to this, denying me those preventive measures ended up costing the taxpayers one big pile of dollars. Hades, the bill for just 2 days at the rehab to train me to function with metal hip #1 was more that the eventual price that the taxpayers paid for both the bed and chair.
What's wrong with those people (and I apply that to both government and civilian insurance)?

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OTOH ...
by Evie / September 17, 2004 4:52 AM PDT

... why should "insurance" pay for an affordable vaccine?

Evie Happy

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Re: OTOH ...
by Roger NC / September 17, 2004 8:51 AM PDT
In reply to: OTOH ...

Hmmm, well since they started preaching "well care" and "preventive medicine" and such years ago, the insurance companies as well as the health industry, why are they trying to weasel out of paying now to reduce future costs?

Actually, if you were going to have government aid/supplements for any specific type of health care other than emergency care, vaccines would be a good place to consider starting, espcially for everyone under 20 and over 60.

Vaccines and (unpopular opinion following warning) birth control to any adult that asked for it. That would be another place I'd be willing to consider it.

Both would almost certainly save goverment cost in the long run.


RogerNC

click here to email semods4@yahoo.com

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I'm remembering ...
by Evie / September 17, 2004 9:08 AM PDT
In reply to: Re: OTOH ...

... a recent thread about getting less and less while paying more and more. If you look at what insurance covers these days, we may be paying more and more, but we are also getting more and more.

Personally, I would rather have true insurance and pay for such manageable preventative costs myself. Maybe one solution that would pay off all the way around would be for insurers to offer premium discounts for those that get the vaccinations, etc.

But in the end, isn't protecting one's own health incentive enough to avail oneself of such things? I see flu shot clinics in the grocery store every year where you can get a shot for like $5. It seems that the paperwork required alone for insurance to provide for that shot makes no sense.

FYI, I do currently have HMO insurance because it is our best value. But if the hubby and I could have different insurance through his employer I would choose the other, much cheaper, option for myself and bank the difference.

I see your point that it would be to the insurer's benefit as well as the insured. Just seems that the more that is covered, the more we pay one way or the other. I would rather pay the $20 for a specific vaccine than $20 more in premiums.

Evie Happy

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About those $5 flu shots ...
by Bill Osler / September 17, 2004 11:41 AM PDT
In reply to: I'm remembering ...

Unless they get a better deal than we do, the vaccines are being subsidized. I don't remember exactly what we pay, but I think it is approximately $5 per dose. When you factor in the supplies, the nurse's time (at $15-30/hour depending on qualifications) and the paperwork there is no way they are breaking even at $5 a pop.

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Probably subsidized ...
by Evie / September 17, 2004 12:07 PM PDT

... but that only adds to the point that there are other options besides insurance "paying for" these type services. I would still rather pay $20 directly for a shot than an additional $20 in premiums that might or might not cover said service.

On the flip side, there are those that do not want to take the vaccine (I think James has stated his objection here a few times). If insurance covers the vaccine, you don't take it, and catch the virus, one has to wonder if there might be some issues over the coverage. AFAIK, my insurance covers one "well woman" visit a year, although it is not mandatory. You have to wonder how long such preventive measures will be covered without some requirement that they be taken so that the insurer can see the benefit.

That reminds me I'm late for my smash'm'ogram Shocked

Evie Happy

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Speaking of -grams
by Bill Osler / September 17, 2004 1:00 PM PDT

I don't know if the site sets cookies or has popups. IE didn't warn me about any, and my popup blocker didn't let any through. I've always been amused by this cartoon:

manogram

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(NT) (NT) LOL!
by Evie / September 17, 2004 1:16 PM PDT
In reply to: Speaking of -grams
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More seriously ...
by Bill Osler / September 17, 2004 1:03 PM PDT

I used to have a dental insurance policy that paid for 100% of preventive services, but it only paid for a portion of restorative services, fillings, et cetera. The copay for the restorative services dropped every year as long as I received annual preventive services and after a couple of years the copay virtually disappeared.

That company believed strongly in preventive dental care.

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Re: More seriously ...
by Evie / September 17, 2004 1:28 PM PDT
In reply to: More seriously ...

That sounds like a great insurance plan. But realistically, if you do go for regular checkups, it's highly unlikely you ever need the restorations. Even with regular checkups there's far more that can go wrong with the whole body. This year the dental insurance offered by my hubby's employer cost too much to be worth it. Unless you needed enough work to max out the yearly benefit, it wasn't worth it. So we signed up for one of those dental plans -- I basically pay 100% of what the insurance company negotiated rate is for services at dentists that are part of the plan. My luck my current providers are all on the list, so for the "maintenance" stuff it's working out great. The dentist likes it cuz no forms and I pay cash, I like it cuz I get a discount and there is no annual maximum on the off chance I needed more than $1K of work done. I've seen some medical plans popping up that are similar.

What's your take on mammograms? I have a family history so they suggest one every year, although I just looked through insurance and now that seems to be the recommendation is for every woman over 40. This seems to be far more regularly than I remember hearing only a few years ago. I also remember hearing about how mammograms can actually trigger breast cancer, and if I recall it was a peer-review study. In Mom's case, she had a clean mammogram before her doctor found a lump about 8 months later when she went in for an unrelated issue. I always kinda wonder about that, but then again don't want to worry needlessly over crackpot theories.

Thanks for your input!
Evie Happy

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Science re: mammograms is uncertain ...
by Bill Osler / September 17, 2004 1:45 PM PDT
In reply to: Re: More seriously ...

My take, at least for now, remembering that I am not an oncologist:

There is no value (for most women) in getting mammograms before age 40. Nobody really knows the answer from age 40-49. Most of the controversy involves this age group and, despite all the rhetoric, the research is currently not conclusive. Everybody is making a guess. Most people agree that mammograms make sense annually beginning at age 50. There is one prominent group (Cochrane Collaborative in the UK) that questions this but almost nobody agrees with them. I wouldn't bet against the Cochrane folks ordinarily but at this point it is so politically incorrect to challenge the value of mammograms that nobody will ever sponsor a trial to see whether they are right or not.

For women under age 50, the problem is that the breasts are different than they are in women over age 50, at least from a statistical perspective, because the average age of menopause is about age 50. Mammograms have been thoroughly tested for post-menopausal women, but the data are less clear for pre-menopausal women, and the cancers that pre-menopausal women get behave differently from the ones that post-menopausal women get.

What I tell patients:

The 'expert opinion' is that if you have a family history of breast cancer in a close relative you need to begin mammograms 10 years younger than your relative was diagnosed. There is no science to support this, but it makes sense.

Begin mammograms by age 50 for all women.

For women between 40 and 50 I tell them to do whichever they prefer. The one thing I feel strongly about, though, is that if you do mammograms between 40 and 50 you need to do them every year. Cancers in this age group are less common than in older women but they are more aggressive in most cases, so it makes no sense at all to go every other year.

IOW, if you have no family history, begin annual mammograms by age 50, and by age 40 if you want to.

If you have a family history of breast cancer in a close relative younger than age 60 at the time of diagnosis, begin mammograms annually no later than 10 years younger than your relative was at the time of diagnosis.

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(NT) (NT) Sigh. Guess I'd better go for my mammomash too. :(
by Cindi Haynes / September 18, 2004 10:15 AM PDT
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Yep Dave, and also J. like Angeline mentioned...
by John Robie / September 15, 2004 12:23 PM PDT

the pneumonia shot will not protect against all types.

I took the shot several years ago, and have never had pneumonia before, but came down with pneumonia this past June and spent 5 days in the hospital. They only identified it as a General Pneumonia. Course I have been more succeptable for pneumonia since Feb 03.

Surprised you have not been taking the shots from long ago since you indicate you have a medical problem requiring assistance in mobility.

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It's unusual, John...
by J. Vega / September 15, 2004 12:40 PM PDT

John, I was in an unusual situation. I have "tap danced" around it for years, especially at the Forums. Let's just say that I didn't want it that way. I can't go anywhere out of the house on my own, I must be taken by someone else. My recent visit to the doctor's was the first in over 18 months. That is going to change shortly, as soon as an official schedules something.

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Dear J - I'm trying to remember...
by Mosonnow / September 18, 2004 4:20 AM PDT
In reply to: It's unusual, John...

When we were talking about bleepers, I got the impression that you were in a fairly remote area. I think this is because I recalled that you did farming, even though I had also understood your professional skills to be in the TV/Sound Engineering field. Of course, my memory is not what it was... I live in the centre of London, so my conception of distances in the US leaves a lot to be desired.

When you move, will you be in the centre of things? (I can't find Snelville on my atlas, doh!)

Regards
Mo

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Basicall, Mo...
by J. Vega / September 18, 2004 4:41 AM PDT

Basically, Mo, I worked in the TV racket for Public Television and then as one of the original gang at CNN. Then the U.S. Government hired me to work in Washington D.C.
I just happened to buy a small farm on which to live and did grow things, but that was just something that I enjoyed, my government salary was still coming in.
Snellville was a tiny little town just to the north of Atlanta when I lived in outside of it, but since it's been "swallowed" by the Metro Atlanta expansion of suburbs and businesses.
Currently, although my little farm is also being surrounded by new suburbs, it's still remote in a sense for me with my physical situation. It's not really wise nor safe for me to live in this house alone, so I will move south and live in the vicinity of friends and relatives. I look forward to getting down there, conditions there be, as I once joked previously, like Christmas in comparison.

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