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Adults years of age with no history of pneumococcal vaccination, including individuals at increased risk of developing pneumococcal disease. A Phase 3 descriptive study included individuals with stable underlying medical conditions e. Section Navigation. Facebook Twitter LinkedIn Syndicate. Pneumococcal Vaccines. Minus Related Pages. On This Page. Pneumococcal Vaccine Side Effects Pneumococcal vaccines are very safe and effective at preventing pneumococcal disease.
Common Side Effects of Pneumococcal Vaccine. Feeling drowsy Loss of appetite Sore or swollen arm from the shot Fever Headache. PCV13 protects against the 13 types of pneumococcal bacteria that cause the most severe illness among children and adults.
It is recommended for routine use among children younger than 5 years of age and adults 65 years of age and older. Is PPSV23 contraindicated in pregnancy? Our patient has asthma and is pregnant. PPSV23 is recommended in pregnancy if some other risk factor is present for example, on the basis of medical, occupational, lifestyle, or other indication.
For more information refer to the adult schedule available at www. Can you please explain when and why the recommendations for vaccination were changed for people with asthma and for cigarette smokers? In , the Advisory Committee on Immunization Practices ACIP reviewed information that suggests that asthma is an independent risk factor for pneumococcal disease among adults. ACIP also reviewed information that demonstrates an increased risk of pneumococcal disease among smokers.
Since PPSV23 is recommended for all adults who smoke, should adults who use smokeless tobacco products e. ACIP does not identify people who use smokeless tobacco products as being at increased risk for pneumococcal disease or as being in a risk group recommended for vaccination. Since PPSV23 is recommended for all adults who smoke, should adults who vape nicotine, but do not smoke cigarettes, be vaccinated too?
ACIP does not identify people who use nicotine vaping products as being at increased risk for pneumococcal disease or as being in a risk group recommended for vaccination. Should we also vaccinate year-olds who smoke? Currently no data exist to indicate that people younger than 19 and smoke are at increased risk of pneumococcal disease. Is PPSV23 indicated for former smokers? PPSV23 is currently recommended for people age 19 through 64 years who actively smoke cigarettes see www.
However, chronic lung disease is an indication for PPSV23, which could be applicable for former smokers. Does a patient younger than age 65 years who smokes marijuana on a daily basis, but doesn't smoke cigarettes, need to receive pneumococcal polysaccharide PPSV vaccine?
ACIP does not identify people who smoke marijuana but not cigarettes as being at increased risk for pneumococcal disease or as being in a risk group for PPSV vaccination. Is PCV13 recommended for adults age 19 through 64 years who smoke? PCV13 is only recommended for adults age 19 through 64 years at increased risk of invasive pneumococcal disease because of an immunocompromising condition, asplenia, CSF leak or cochlear implant. Why isn't PPSV23 recommended for children with asthma?
Available data do not indicate that asthma alone increases the risk of invasive pneumococcal disease among people younger than 19 years, so PPSV23 is not currently recommended for people younger than 19 years with asthma. For more information, go to www. Would you include obstructive sleep apnea as chronic pulmonary disease which would require PPSV23 vaccination once for adults under the age of 65? Obstructive sleep apnea alone is not an indication for vaccination with PPSV23 for persons 2 through 64 years of age.
People with obstructive sleep apnea often have other pulmonary conditions such as chronic obstructive pulmonary disease that would put them at increased risk for invasive pneumococcal disease, for which they should be vaccinated. A table listing risk conditions and pneumococcal vaccine recommendations can be found at www. Should people who are HIV positive receive pneumococcal vaccines? People with HIV infection are at high risk of pneumococcal disease.
If they are age 65 years or older when first diagnosed, they will need only one dose. Is systemic lupus erythematosus SLE, lupus a risk-based indication for pneumococcal vaccines? Lupus per se is not an indication for either pneumococcal vaccine. However, immunosuppressive medication that may be used to treat lupus could create an indication for administering both pneumococcal vaccines.
Also, if the patient has certain complications of lupus such as nephrotic syndrome , the person would be a candidate for pneumococcal vaccines. A handy document that summarizes indications for both pneumococcal vaccines is available at www.
Does her illness fall under the criteria for administering PPSV23? How often should diabetic patients receive PPSV23? People with either type 1 or type 2 diabetes who are ages 2 through 64 years who have not already received a dose of PPSV23 should receive their first dose now. At age 65 years they should receive a one-time revaccination if 5 years have elapsed since the previous dose.
Diabetes is not an indication for PCV13, however persons 65 years and older may be considered for PCV13 vaccination based on shared clinical decision-making between the provider and patient.
PPSV23 is recommended for people with diabetes. Does this include gestational diabetes? How often should adult dialysis patients receive pneumococcal polysaccharide vaccine?
Once they become age 65, they will need another PPSV23 dose. If they were age 65 years or older when first vaccinated, only one dose of PPSV23 is recommended. Adults age 19 years and older with immunocompromising conditions including chronic renal failure , functional or anatomic asplenia, CSF leak, or cochlear implants, who previously have received 1 or more doses of PPSV23 should be given a PCV13 dose at least 1 year after the last PPSV23 dose was received. Adults who receive PPSV23 at or after age 65 years should receive only a single dose.
A 5-year interval is recommended between PPSV23 vaccine doses. A second PPSV23 given 5 years after the first dose is recommended for people age 19 through 64 years who have functional or anatomic asplenia including persons with sickle cell disease or splenectomy patients ; chronic renal failure including dialysis patients or nephrotic syndrome; are immunocompromised, including those with HIV infection, leukemia, lymphoma, Hodgkin disease, multiple myeloma, generalized malignancy; are receiving immunosuppressive therapy including long-term systemic corticosteroids or radiation therapy ; or who have received a solid organ transplant.
Patients who received 1 or 2 doses of PPSV23 for any indication at age 64 years or younger should receive an additional dose of PPSV23 vaccine at age 65 years or older if at least 5 years have elapsed since their previous PPSV23 dose. Should a healthy year-old patient who was given PPSV23 at age 65 years be revaccinated? Adults who were first vaccinated at age 65 years or older do not require any more doses of PPSV Why is there no recommendation for patients older than 65 years to get a booster dose of PPSV23 if they first received it at age 65 years or older?
It seems to me that their protection against pneumococcal disease would benefit from a booster dose of PPSV23 five or ten years after the first dose. People age 65 and older should be given a second dose of PPSV23 if they received the first dose 5 or more years previously and were younger than 65 years at the time of the first vaccination.
The benefit and safety of a second dose given after age 65 years is uncertain. Until such data are available, ACIP recommends only a single dose at age 65 years or older. Should I still use it? So, although PPSV23 is not as effective as some other vaccines, it can significantly lower the risk of serious pneumococcal disease and its complications in most recipients. My patient has had laboratory-confirmed pneumococcal pneumonia.
There are more than 90 known serotypes of pneumococcus 13 serotypes in the conjugate vaccine and 23 serotypes in the polysaccharide vaccine. Infection with one serotype does not necessarily produce immunity to other serotypes. If influenza vaccine is recommended for healthcare workers to protect high-risk patients from getting influenza, why aren't the pneumococcal vaccines also recommended?
Influenza virus is easily spread from healthcare workers to their patients, and infection usually leads to clinical illness. Pneumococcus is probably not spread from healthcare workers to their patients as easily as is influenza, and infection with pneumococcus does not necessarily lead to clinical illness. Host factors such as age, underlying illness are more important in the development of invasive pneumococcal disease than nasopharyngeal colonization with the organism.
When you're giving influenza vaccine to your patients in the fall, don't forget to assess their need for pneumococcal vaccines as well as all other vaccines, including Tdap and zoster. Why should we not give PCV13 vaccine to someone who has had a serious reaction to a diphtheria-containing vaccine in the past?
PCV13 vaccine is conjugated to a type of diphtheria-toxoid. So if someone has a past history of anaphylaxis following diphtheria-containing vaccine, it might be due to the diphtheria toxoid, and the cause of the anaphylactic allergy should be identified before the administration of PCV13 vaccine.
This could be difficult since no single-antigen diphtheria toxoid is available in the U. Fortunately, true anaphylactic allergy to diphtheria-containing vaccine is rare. If not, what is the recommended interval between doses? What dosing intervals should be observed when giving PCV13 and PPSV23 to patients children and adults who are recommended to receive both vaccines? For adults age 19 through 64 years with other high-risk conditions e.
For people age 65 years and older with no prior pneumococcal vaccination who do not have a high-risk condition, but a decision is made, based on shared clinical decision-making, to give PCV13, give PCV13 followed by PPSV23 one year later.
Rather than giving PCV13 first and waiting 8 weeks to give PPSV23 as recommended for an immunocompromised child 2 years or older or adult patient, we inadvertently gave both vaccines at the same visit. We are looking for guidance. However, in adults, if PCV13 and PPSV23 are administered at the same visit or at an interval less than 8 weeks, neither dose needs to be repeated. In children, if PCV13 and PPSV23 are administered at the same visit, the PCV13 dose should be repeated, and should be administered no earlier than 8 weeks after doses that were administered on the same day.
She had not received PPSV23 previously. Is the PPSV23 dose valid, or does it need to be repeated? Even though the interval was shorter than the recommended one year, the dose of PPSV23 should be counted and does not need to be repeated.
Among persons age 65 years and older without CSF leak, asplenia, immunocompromising conditions, or cochlear implant, the interval is one year between PCV13 and PPSV23 when both vaccines are recommended. The CDC subject matter experts have provided the following guidance: in such a case, the dose given second does not need to be repeated. The recommended interval between the dose of PCV13 and PPSV23 is one year and the recommended minimum interval between doses is 8 weeks.
We have a healthy year-old patient who received a dose of PPSV23 in January then received a dose of PCV13 five months later at a different facility.
If PCV13 is given based on having a high-risk condition e. The CDC subject matter experts have advised that in such a case, the dose given second does not need to be repeated. There is no evidence to support that there are benefits to repeating the dose of PCV Information about the recommended intervals between pneumococcal vaccines can be found at www. If patients who are in a recommended risk group for PPSV23 or PCV13 aren't sure if they have previously received these vaccines, should healthcare providers vaccinate them?
If patients do not have a documented vaccination history for these two vaccines and their records are not readily obtainable, you should administer the recommended doses. Extra doses will not cause harm to the patient.
An year-old patient came in today and stated he needed a pneumococcal vaccine booster. He reports receiving a dose of "pneumonia vaccine" when he was 77 years old. And PCV13 is given as a one-time dose when given to adults. If the person received their first pneumonia vaccine before , they would have received PPSV If the person is unsure which pneumococcal vaccine they received and they do not have documentation, then they should receive PPSV The provider and patient may consider PCV13 vaccination based on shared clinical decision-making if the person does not have a high-risk indication for PCV13 i.
We just gave PPSV23 to a year-old patient who is newly diagnosed with a medical condition that places him at increased risk for pneumococcal disease and its complications. Should we give him a second dose in 5 years because of his underlying medical condition? People who are first vaccinated with PPSV23 at age 65 years or older should receive only one dose, regardless of any underlying medical condition they might have.
Antibiotics are used to treat pneumococcal disease, but some strains of the bacteria have developed resistance to some of the drugs used against them. Drug resistance can complicate treatment and increase the length of hospital stays. Invasive pneumococcal disease and pneumococcal pneumonia can be extremely serious and often require hospitalization.
Each year in the United States, pneumococcal bacteria cause more than 4, cases of invasive pneumococcal disease in children younger than five years of age.
Of those who survive, some are left with permanent injury. A pneumococcal vaccine that protected against 14 different strains was licensed in , and expanded to protect against 23 strains in However, it is most effective in adults, and does not consistently generate immunity in children younger than two years old.
A separate vaccine for children called PCV7 was licensed in PCV7 is a conjugate vaccine see our article, Different Types of Vaccines , for more on how these vaccines are made ; it was expanded to include protection against 13 strains in , and renamed PCV13 brand name Prevnar 13, manufactured by Pfizer. PCV13 protects against the bacterial strains responsible for the most severe childhood pneumococcal infections.
PCV7 was added to the recommended childhood vaccination schedule in PCV13 replaced it on the schedule in Pneumococcal vaccination via PCV13 is included on the U. Additional protection via the polysaccharide vaccine PPSV23 is recommended for children with certain underlying medical conditions. The PPSV23 vaccine is also recommended for adults with certain risk factors for pneumococcal disease up to age 65, including asthma and cigarette smoking.
In , the Advisory Committee on Immunization Practices recommended that adults age 65 and older also receive pneumococcal conjugate vaccine PCV. Therefore, at age 65, adults who have never received pneumococcal vaccine should receive a single dose of PCV13 followed months later by a dose of PPSV Centers for Disease Control and Prevention. Pneumococcal Disease. Epidemiology and Prevention of Vaccine-Preventable Diseases. Atkinson, W. Pneumococcal vaccination: What everyone should know.
Morbidity and Mortality Weekly Report. Muller, M. Pediatric bacterial meningitis. Merck licensed a polysaccharide vaccine protecting against 14 types of pneumococcal bacteria in In , Merck expanded on this work by producing a vaccine against 23 types of pneumococcal bacteria.
One challenge in producing a pneumococcal vaccine involved determining which of the more than 90 types of pneumococcal bacteria produced the most disease. Once that work was complete, Robert Austrian, MD, at the University of Pennsylvania isolated the types most appropriate for the vaccine and provided this information to Hilleman at Merck.
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