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Pneumococcal Vaccine
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Pneumococcal Vaccine
, Polyvalent pneumococcal Vaccine, Pneumovax 23, Pneumovax, Pnu-Imune 23
See Also
Pneumococcal Conjugate Vaccine
Pharmacokinetics
Purified capsular polysaccharide
Antigen
s from 23 serotypes
These serotypes are responsible for 88% of invasive pneumococcal disease
Indications
Adult
Vaccine
Age 65 years and older
Sickle Cell Disease
Functional or anatomic
Asplenia
Administer 2 weeks prior to splenectomy
Nephrotic Syndrome
or
Chronic Renal Failure
Immunosuppression
Human Immunodeficiency Virus
Heart, lung or liver disease
Asthma
Tobacco
users (starting at age 50 years)
High risk environments
Native American Reservations
Nursing Home
s
Indications
Children (age 2 years and older)
Chronic illness (including
Corticosteroid
dependent
Asthma
)
Functional Asplenia
or anatomic
Asplenia
Immunocompromised state
Renal disease (e.g.
Nephrotic Syndrome
,
Renal Failure
)
Dosing
One dose is sufficient for most patients at age 65 years
Indication for single dose ages 2 to 64 years
See Indications above
Give a second dose at age 65 or at least 5 years after the last dose
Indication for 2 doses at more than 5 years apart at ages 2 to 64 years
Give third dose at age 65 years or at least 5 years after the last dose
Chronic renal disease (
Renal Failure
,
Nephrotic Syndrome
)
Asplenia
Sickle Cell Anemia
Immunocompromised state
HIV Infection
Leukemia
Lymphoma
Multiple Myeloma
Iatrogenic (e.g. organ transplant,
Radiation Therapy
,
Chemotherapy
)
Timing with
Prevnar 13
(recommended as of 2012 for immunocompromised adults)
CDC modified
Prevnar 13
recommendations for healthy seniors in 2019
Pneumovax 23 alone (without
Prevnar 13
) is sufficient in healthy seniors
NNT 2600
Prevnar 13
vaccinated healthy seniors to prevent one case of
Pneumonia
Prevnar 13
Vaccine
in children as
Primary Series
has protected seniors via
Herd Immunity
(2019) Presc Lett 26(9): 49
No prior Pneumovax or immunocompromised state
Give Pneumovax 23 at least 8 weeks after
Prevnar 13
Prior Pneumovax
Give
Prevnar 13
at least one year after Pneumovax 23
Schedule for those over age 65 years
No prior Pneumovax 23
Prevnar 13
after age 65 year birthday AND
Pneumovax 23 at 6-12 months after
Prevnar 13
dose (8 weeks if immunocompromised)
Prior Pneumovax 23 after age 65 year birthday
Prevnar 13
after age 65 year birthday
No further Pneumovax 23 needed
Prior Pneumovax 23 before age 65 year birthday
Prevnar 13
after age 65 year birthday AND at least one year after Pneumovax 23 AND
Pneumovax 23 at 12 months after
Prevnar 13
dose AND 5 years after last Pneumovax 23
References
(2014) Presc Lett 21(11): 63-64
Precautions
Administer to high risk women before pregnancy
ACIP recommends avoiding in pregnancy
Pneumococcal Vaccine may be given on same day as other
Vaccine
s (e.g.
Influenza Vaccine
,
Shingles Vaccine
)
Prevnar
Vaccine
may have reduced
Antibody
response when given with
Influenza Vaccine
However, given both
Vaccine
s (
Prevnar
and
Influenza
) does not reduce their efficacy
References
Presc Lett 22(11): 63
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