How does pneumococcal polysaccharide vaccine work

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. When should I vaccinate children or adults who are planning to have either a cochlear implant or elective splenectomy? It is preferable that the person planning to have the procedure have antibody to pneumococcus at the time of the surgery; if possible, administer the appropriate vaccine prior to the splenectomy or cochlear implant.

Children 2 through 71 months of age should continue to receive PCV13 vaccine according to the schedule. If the procedure is done on an emergency basis, vaccinate as soon as possible after surgery. Persons who have not previously received any pneumococcal vaccine should receive PCV13 first followed by PPSV23 at least 8 weeks later. Do any of the bacterial vaccines that are recommended for people with functional or anatomic asplenia need to be given before splenectomy?

Do the doses count if they are given during the 2 weeks prior to surgery? Pneumococcal conjugate vaccine PCV13 , Haemophilus influenzae type b vaccine, meningococcal conjugate vaccine, and meningococcal B vaccine should be given 14 days before splenectomy, if possible.

Doses given during the 2 weeks 14 days before surgery can be counted as valid. If the doses cannot be given prior to the splenectomy, they should be given as soon as the patient's condition has stabilized after surgery. Pneumococcal polysaccharide vaccine should be administered 8 weeks after the dose of PCV13 for people 2 years of age and older. All children with risk factors for pneumococcal disease or its complications should be vaccinated with PPSV23 beginning at age 2 years.

Some physicians in our area order PPSV23 every 5 years for their patients. Is this correct? Only certain high-risk people who were vaccinated when younger than age 65 years will need a second dose 5 years later. At age 65 years or older, all adults including people vaccinated when younger are recommended to have a single dose of PPSV Can we vaccinate a 2-year-old boy with functional or anatomic asplenia against meningococcal disease if he has not completed a series of PCV13? We have a year-old getting renal dialysis.

The nephrologist will be starting her on a monoclonal antibody that interferes with C5 complement. A 10 year-old with persistent complement component deficiency should also receive a 2 or 3 dose series depending on brand of meningococcal B vaccine.

Yes, with several exceptions. PPSV23 and PCV13 are both inactivated vaccines, which means you can give all other recommended vaccines at the same visit using separate syringes or at any later time with no waiting period following the vaccination. Here are the exceptions: 1. The pneumococcal conjugate vaccine PCV13 package insert says that in adults, antibody responses to Prevnar 13 Pfizer were diminished when given with inactivated influenza vaccine.

Does this mean we should not give PCV13 and influenza vaccine at the same visit? The available data have been interpreted that any changes in antibody response to either vaccines' components were clinically insignificant. If PCV13 and influenza vaccine are both indicated and recommended they should be administered at the same visit.

What intervals should be observed between doses of PCV13 and PPSV23 for those children and adults who are recommended to receive both vaccines? For adults at increased risk of pneumococcal disease such as immunocompromising conditions or asplenia give PCV13 first followed by PPSV23 in at least 8 weeks. For adults age 19 years and older who have received one or more doses of PPSV23 previously, wait one year before giving PCV13 to avoid interference between the 2 vaccines. The Zostavax vaccine Merck package insert says that Zostavax should not be given simultaneously with pneumococcal polysaccharide vaccine PPSV What does ACIP say about this?

ACIP has not changed its recommendation on the simultaneous administration of these two vaccines i. Administering Vaccines Back to top A dose of pneumococcal conjugate vaccine was administered into my patient's dialysis port. Does this dose count? There are no data on the effectiveness of pneumococcal conjugate vaccine given by the intravenous route. The patient has renal disease, so it is important to ensure that the dose they receive is effective.

CDC recommends repeating the dose. What route and needle length is recommended for administration of pneumococcal polysaccharide vaccine? What route and needle length should we use for administration of pneumococcal conjugate vaccine PCV13? Storage and Handling How should pneumococcal vaccines be stored? Do not freeze either vaccine. Vaccine exposed to freezing temperature should not be administered. Back to top This page was updated on October 22, Therefore, it is regularly available for children at:.

Federally funded health centers can also provide services if you do not have a regular source of health care. Locate one near you external icon. You can also contact your state health department to learn more about where to get pneumococcal vaccines in your community. When receiving any vaccine, ask the provider to record the vaccine in the state or local registry, if available. This helps doctors at future encounters know what vaccines you or your child have already received.

Most private health insurance plans cover pneumococcal vaccines. Check with your insurance provider for details on whether there is any cost to you. Ask your insurance provider and for a list of in-network vaccine providers. The Vaccines for Children VFC Program provides vaccines to children whose parents or guardians may not be able to afford them.

A child is eligible if they are younger than 19 years old and meets one of the following requirements:. Skip directly to site content Skip directly to page options Skip directly to A-Z link. Vaccines and Preventable Diseases. Section Navigation. Apart from the active ingredients the antigens , it contains very small amounts of these ingredients:. Other brands of PPV used in other countries may contain different ingredients. If you are not in the UK, ask for the Patient Information leaflet for the vaccine you are offered.

As with any vaccine, medicine or food, there is a very small chance of a severe allergic reaction anaphylaxis.

It is always extremely serious but can be treated with adrenaline. Health care workers who give vaccines know how to do this. In the UK between and there were a total of reports of anaphylaxis following ALL immunisations.

Around million doses of vaccines were given in the UK during this period. This means that the overall rate of anaphylaxis is around 1 in , See Vaccine side effects and adverse reactions for more information on why this is the case. If you are concerned about any reactions that occur after vaccination, consult your doctor.

See more information on the Yellow Card scheme and monitoring of vaccine safety. The Summary of Product Characteristics for Zostavax, the shingles vaccine used in the UK, states that the vaccine should not be given at the same time as the Pneumococcal Polysaccharide Vaccine. This is because a clinical trial by the manufacturer had suggested this might make Zostavax less effective.

However, the Department of Health advice is that the two vaccines can be given at the same time. This is based on expert advice from the Joint Committee on Vaccination and Immunisation , and on research that showed no evidence that people receiving both vaccines together had any increased risk of developing shingles.

Read the abstract of the study by Tseng et al. A Cochrane review looked at 25 studies of PPV vaccine effectiveness in over , people.

It found strong evidence that the PPV was effective against invasive pneumococcal disease meningitis and septicaemia in adults. This immune response usually occurs within 2 to 3 weeks after vaccination. Older adults and persons with some chronic illnesses or immunodeficiency may not respond as well. Elevated antibody levels persist for at least 5 years in healthy adults but decline more quickly in persons with certain underlying illnesses.

Children younger than 2 years of age generally have a poor antibody response to PPSV PPSV23 vaccine efficacy studies have resulted in various estimates of clinical effectiveness. There is no consensus regarding the ability of PPSV23 to prevent non-bacteremic pneumococcal pneumonia. Studies comparing patterns of asymptomatic pneumococcal carriage before and after PPSV23 vaccination have not shown decreases in carrier rates among those vaccinated.

Consult the following package inserts for proper storage and handing details, shelf life, and reconstitution instructions:. Skip directly to site content Skip directly to page options Skip directly to A-Z link.