Pneumococcal vaccine what is it

These vaccines are very effective at preventing severe disease, hospitalization, and even death. Kids may have redness, tenderness, or swelling where the shot was given. A child also might have a fever after getting the shot.

There is a very small chance of an allergic reaction with any vaccine. The pneumococcal vaccines contain only a small piece of the germ and so cannot cause pneumococcal disease. These vaccines may cause mild fever and soreness or redness in the injection area. Check with your doctor to see if you can give either acetaminophen or ibuprofen for pain or fever and to find out the right dose.

Symptoms include abrupt onset of fever, shaking chills or rigors, chest pain, cough, shortness of breath, rapid breathing and heart rate, and weakness. More than 5, cases of pneumococcal bacteremia without pneumonia occur each year in the United States. There are an estimated 2, cases of pneumococcal meningitis each year. Symptoms and signs may include headache, tiredness, vomiting, irritability, fever, seizures, and coma.

Permanent neurological damage is common among survivors. How serious is pneumococcal disease in the U. Pneumococcal disease is a serious disease that causes much sickness and death. An estimated 31, cases and 3, deaths from invasive pneumococcal diseases IPD-bacteremia and -meningitis occurred in the United States in see www.

Young children and the elderly younger than age two years and older than 50 have the highest incidence of serious disease. Case-fatality rates are highest for pneumococcal meningitis and bacteremia, and the highest mortality occurs among the elderly and patients who have underlying medical conditions. In , the first pneumococcal conjugate vaccine PCV was licensed in the U. Together, these 13 serotypes account for the majority of invasive pneumococcal disease IPD in the U.

PCV7 was initially recommended for routine use in infants and children ages 2 through 59 months. The recommendations were expanded with the licensure of PCV13 to include vaccination of children age 60 through 71 months with underlying medical conditions, and also vaccination of older children, ages 6 through 18 years, with medical conditions placing them at increased risk of invasive pneumococcal disease.

What are the recommendations for routine vaccination of children with PCV13? All infants should be given a primary series of PCV13, at ages 2, 4, and 6 months with a booster at age 12 to 15 months. Children who fall behind should be given catch-up vaccination through age 59 months, if otherwise healthy or, through age 71 months if they have certain underlying medical conditions.

A healthy child received only one dose of PCV13 at age 10 months. She is now 6 years old. Our state requires one dose of PCV13 after the first birthday for school attendance.

Her physician says because she is older than 59 months, she does not need another dose of PCV What should we do in this situation? If there is a school requirement, the simplest solution is to give the child one dose of PCV However, health insurance may not pay for this dose. For more information on the ACIP recommendations for pneumococcal vaccination of children, go to www. Which underlying medical conditions indicate that a child age 6 through 18 years should receive PCV13? Routine use of PCV13 is not recommended for healthy children 5 years of age or older.

For people not vaccinated 2 weeks prior, vaccinate as soon as possible. IAC has produced a document that describes pneumococcal vaccination recommendations based on the child's current age and prior vaccination history. The document is available at www.

What should be done? PPSV23 is not effective in children less than 24 months of age. PPSV23 given at this age should not be considered to be part of the pneumococcal vaccination series. PCV13 should be administered as soon as the error is discovered. Are there data that state these should not be given concomitantly? A CDC study has shown a small increased risk for febrile seizures during the 24 hours after a child receives the inactivated influenza vaccine at the same time as the PCV13 vaccine or DTaP vaccine.

However, the risk of febrile seizure with any combination of these vaccines is small and ACIP recommends giving these vaccines at the same visit if indicated. See www. Instead, shared clinical decision-making for PCV13 use is recommended for adults age 65 years and older who do not have an immunocompromising condition, cerebrospinal fluid CSF leak, or cochlear implant.

PCV13 continues to be recommended for all adults with immunocompromising conditions, cerebrospinal fluid CSF leak, or cochlear implant. Immunocompromising conditions include chronic renal failure, nephrotic syndrome, congenital or acquired immunodeficiency, iatrogenic immunosuppression, generalized malignancy, human immunodeficiency virus, Hodgkin disease, leukemia, lymphoma, multiple myeloma, solid organ transplants, congenital or acquired asplenia, sickle cell disease, or other hemoglobinopathies.

The incidence of PCVtype disease has been reduced to historically low levels among adults age 65 years and older through indirect effects from pediatric PCV13 use. Because of this changing epidemiology, ACIP updated its recommendations on PCV13 vaccine scheduling in older adults and incorporated the concept of shared clinical decision-making, as summarized in the question and answer below.

Pneumococcal polysaccharide vaccine PPSV23, Pneumovax, Merck continues to be recommended for all adults age 65 years and older. For more information, the most recent ACIP pneumococcal vaccine recommendations can be accessed at: www. When patients and vaccine providers engage in shared clinical decision-making for PCV13 use to determine whether PCV13 is right for the specific individual age 65 years and older, considerations include the individual patient's risk for exposure to PCV13 serotypes and the risk for pneumococcal disease for that person as a result of underlying medical conditions.

These considerations are detailed below. The risk for PCVtype disease among adults age 65 years and older is much lower than it was before the pediatric program was implemented. The remaining risk is a function of each individual patient's risk for exposure to PCV13 serotypes and the influence of underlying medical conditions on the patient's risk for developing pneumococcal disease if exposure occurs. Although indirect effects from pediatric PCV13 use were documented for these groups of adults and were comparable to those observed among healthy adults, the residual PCVtype disease burden remains higher in these groups.

Providers and practices caring for patients with these medical conditions may consider offering PCV13 to such patients who are age 65 years and older and who have not previously received PCV Did the recommendation change in November for PPSV23 vaccination of adults age 65 years and older?

Which high-risk adults are recommended to receive a dose of PCV13? Pneumococcal conjugate vaccine PCV13, Prevnar 13, Pfizer is recommended for all adults without a prior PCV13 vaccination who have a high-risk condition, including immunocompromising conditions, cerebrospinal fluid CSF leak, and cochlear implant.

PCV13 can be given to adults age 65 years and older without these high-risk conditions based on shared clinical decision-making. Considerations for PCV13 vaccination of adults age 65 years and older without these high-risk conditions include any potential increased risk for exposure to PCV13 serotypes, such as residing in a nursing home or other long-term care facility, residing in settings with low PCV13 vaccination rates among children, or traveling to areas with no PCV13 vaccination coverage, and their risk of getting pneumococcal disease as a result of underlying medical conditions, such as chronic heart, lung or renal disease, diabetes, alcoholism, or smoking cigarettes.

For complete information on CDC's recommendations for the use of pneumococcal vaccines, go to www. How effective is PCV13 vaccine in adults 65 years and older? PCV13 is licensed for use among adults 50 years of age and older.

I have a patient who takes adalimumab Humira for rheumatoid arthritis. Does a person who takes adalimumab meet the definition of immunosuppression for the purposes of PCV13 vaccination? Adalimumab is a potent anti-inflammatory drug that blocks the activity of tumor necrosis factor TNF. Adalimumab is considered immunosuppressive because serious infections have been reported in people taking the drug, including tuberculosis and infections caused by viruses, fungi, or bacteria.

Consequently, a person taking adalimumab or other drugs that affect TNF activity such as infliximab [Remicade], certolizumab pegol [Cimzia], golimumab [Simponi], or etanercept [Enbrel] should be considered to have immunosuppression and receive PCV13 followed by PPSV23 at least 8 weeks later.

Please explain why pneumococcal polysaccharide vaccine is recommended for smokers or people with diabetes younger than age 65 but pneumococcal conjugate vaccine is not recommended for these groups. The level of risk for pneumococcal disease in smokers and people with diabetes is not as high as in immunocompromised persons, or persons with asplenia, HIV infection, hematologic cancer, or cochlear implant. Because of the lower risk, ACIP recommended that smokers and people with diabetes receive only pneumococcal polysaccharide vaccine PPSV, Pneumovax 23; Merck once before age 65 years, and again at age 65 years or older.

At this age, pneumococcal disease rates increase regardless of health status. One dose of the pneumococcal conjugate vaccine PCV13; Pfizer is recommended for immunocompromised persons, and persons with asplenia, HIV infection, hematologic cancer, or cochlear implant.

If there is no longer a CSF leak, neither vaccine is recommended, unless there is another risk factor for invasive pneumococcal disease or an age-based indication. Does an adult younger than age 65 years with beta thalassemia minor meet the criteria for a recommendation for vaccination with PCV13? Beta thalassemia minor is a hemoglobinopathy, but compared to sickle cell disease, these patients have less risk for functional asplenia, and by extension a reduced risk for invasive pneumococcal disease.

Wouldn't PPSV23 protect them against ten additional strains of the pneumococcal bacteria? PCV13 is recommended to be given first because of the immune response to the vaccine when given in this sequence. An evaluation of immune response after a second pneumococcal vaccination administered 1 year after an initial dose showed that subjects who received PPSV23 as the initial dose had lower antibody responses after subsequent administration of PCV13 than those who had received PCV13 as the initial dose followed by a dose of PPSV What is the definition of a year?

Does it need to be exactly one year? We have provided PCV13 to some individuals during flu season this year and told them to get the PPSV23 next year when they get their flu shot. What if they received their flu shot in November this year, but return for their flu shot in October next year? ACIP does not define "one year" but this is assumed to be one calendar year.

However, it could be a problem for reimbursement since Medicare will only pay for both vaccines if they are given at least 11 months apart. Private insurance may have similar rules.

Here is the wording from the Centers for Medicare and Medicaid CMS : "An initial pneumococcal vaccine may be administered to all Medicare beneficiaries who have never received a pneumococcal vaccine under Medicare Part B. A different, second pneumococcal vaccine may be administered 1 year after the first vaccine was administered i. We have a year-old patient with a history of vasculitis, nephritis, and asthma.

She is on azathioprine Imuran and is immunosuppressed. Her rheumatologist recommends she receive pneumococcal conjugate vaccine and meningococcal B vaccine. How often should these vaccines be given? Will she require a series of PCV13 doses or just a booster?

Meningococcal serogroup B vaccine MenB is not specifically recommended for immunosuppressed people. However, people age 16 through 23 years who are not at increased risk may receive routine MenB vaccination of either a 2-dose series of Bexsero GSK 4 weeks apart, or a 2-dose series of Trumenba Pfizer 6 months apart. We have a year-old patient taking Mesalamine for ulcerative colitis. Mesalamine mesalazine is a non-steroidal anti-inflammatory drug. It is not immunosuppressive, so it's use would not place a person at increased risk of invasive pneumococcal disease.

Can we administer either the pneumococcal polysaccharide PPSV23 or the pneumococcal conjugate vaccine PCV13 to patients with multiple sclerosis? Multiple sclerosis is not a contraindication to any vaccine, including either of the pneumococcal vaccines.

Studies that showed possible interference when PCV7 and Menactra were given simultaneously were done in children. At this time, there are no data to support a similar recommendation for adults. The first pneumococcal vaccine, licensed in , was a polysaccharide vaccine. It contained purified capsular polysaccharide antigen from 14 different types of pneumococcal bacteria. It replaced the valent vaccine. Who is recommended to receive pneumococcal polysaccharide vaccine PPSV23?

HIV infection Hodgkin disease, leukemia, lymphoma, and multiple myeloma Could you briefly summarize the revaccination recommendations for PPSV23?

Children and adults younger than age 65 who are at highest risk for serious pneumococcal infection see categories 9 through 17 in previous answer should get 2 doses of PPSV23 five years apart, with a third dose after they turn age 65 if at least 5 years have passed since the last dose. Patients with risk factors 1 through 8 above should get one dose of PPSV23 before age 65 and then a second dose after they turn 65 years if at least 5 years have passed since the last dose.

Patients with no risk factors should get 1 dose at age Thus, depending on risk and age at vaccination, an adult may have received 1, 2, or 3 doses of PPSV How effective is PPSV23 vaccine for adults 65 years and older? The vaccine is less effective in immunocompromised people. The effectiveness of this vaccine in preventing noninvasive pneumococcal pneumonia among adults age 65 years and older have been inconsistent. Is a patient younger than age 65 years who recently had a prostatectomy with lymph node dissection for prostate cancer a candidate for PPSV23?

The patient is believed to be cancer-free and is on no chemotherapy. In the absence of "generalized malignancy" which is generally considered to mean disseminated cancer or immunosuppression, a recent history of prostate cancer surgery alone is not an indication for PPSV I have patients who are in their 70s and 80s and remember getting a pneumococcal vaccine a few years ago. Should we assume that this was PPSV23? Should I assume that it was given before the 65th birthday?

Ideally, providers and patients should work to verify which vaccines were received, including by querying the jurisdiction's immunization information system where the patient was likely vaccinated.

If vaccination records cannot be obtained, then the patient should be vaccinated. All patients should receive PPSV23 at age 65 years or older. All other vaccines must be documented with a written, dated record. At what age should they receive it? PPSV23 is recommended for children with an immunocompromising condition, or functional or anatomic asplenia, and also for immunocompetent children with chronic heart disease, chronic lung disease, diabetes mellitus, CSF leak, or cochlear implant.

Children with an immunocompromising condition, or functional or anatomic asplenia should receive a second dose of PPSV23 5 years after the first PPSV 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? A single dose of PCV13 is recommended for adults over age 19 years who have a weakened immune system due to HIV infection, organ transplant, leukemia, lymphoma and kidney disease. PPSV23 pneumococcal polysaccharide vaccine , which helps protect you from 23 types of pneumococcal bacteria, is normally given to adults over age 65 and children over age two who may be at high risk for pneumonia.

This form of the vaccine is often used in adults who smoke or have a respiratory disease like asthma. One shot usually protects you for life; however, you may need a booster based on changes in your medical condition. Talk to your doctor and see what is best for you. While you may worry about this disease, not everyone needs a pneumonia vaccine.

If you are healthy and between the ages of 18 and 64, you most likely do not need it. Also, some people may be allergic to the components in the vaccine.

The pneumonia vaccine includes an extract from the actual pneumonia bacteria, but it is not strong enough to cause the illness. Some patients have experienced very mild side effects, including swelling, redness and discomfort at the vaccine site, low-grade fever, irritability, overall achiness and reduced appetite. However, these reactions are reported in less than one percent of patients who have had the injection.

As you can see from Dr. If you fall within the age categories or have the conditions listed, it is important that you talk with your primary care provider PCP now. If you do not have a PCP, Firelands Physician Group has many compassionate and caring physicians who are looking forward to taking care of you, and your family.

To discuss your overall health and see if you need a pneumonia vaccine, please call to make an appointment with Dr.