Pneumococcal vaccine where is it given

People should not get the vaccine if they have had a life threatening allergic reaction to a previous dose. Additionally, a person should not undergo vaccination if they have had an allergic reaction to medication containing diphtheria toxoid or an earlier form of the pneumonia vaccination PCV7. Lastly, people who are sick or have allergic reactions to any of the ingredients of the vaccine should talk to a doctor before getting the shot. A pneumonia shot will not reduce pneumonia. However, it helps prevent invasive pneumococcal diseases, such as meningitis , endocarditis , empyema , and bacteremia, which is when bacteria enter the bloodstream.

Noninvasive pneumococcal disease includes sinusitis. There are two types of pneumonia shots available. Which type a person gets depends on their age, whether or not they smoke, and the presence of any underlying medical conditions.

PCSV23 protects older adults and others who need it against 23 different strains of bacterial pneumonia. Although the pneumonia shots will not prevent a person from ever getting pneumonia, they may help in reducing cases of invasive pneumococcal diseases.

At least one dose of PCV13 protects :. One dose of PCSV23 helps protect about 50—85 out of healthy adults against invasive pneumococcal disease.

If a person receives a second pneumonia shot too soon, they may experience worse side effects than someone receiving the vaccine for the first time. In particular, severe localized, arthritis-like reactions are more frequent. The general CDC guidelines for people who are 65 years of age or older vary, depending on the type of vaccine. If a person received one dose of PPSV23 prior to the age of 65 years, they should get one final shot after this age. However, they should wait until it has been at least 5 years since the first shot.

For example, if they received their first shot at 62 years of age, they should wait until they are 67 years old for the second and final dose. Most people who get the pneumonia vaccine will not experience any side effects. However, as with any medication or vaccine, there is a risk that a person will develop side effects. These side effects typically disappear after a few days. With PCV13, there is some risk of seizure in young children if they receive the shot at the same time as a flu vaccine.

A parent or caregiver should talk to a doctor about the best times to get each shot. A person who is over 65 years of age should talk to their doctor about which pneumonia vaccine may be best for them. The doctor can help determine whether they should get the vaccination, which vaccination to get, and when to get it. Parents and caregivers of young children should talk to a pediatrician about the schedule for the pneumonia vaccination. The pediatrician can also address any questions or concerns about the safety and effectiveness of the vaccination.

This protection was similar among children with and without medical conditions that put them at increased risk of pneumococcal disease. The vaccine is also effective at preventing antibiotic-resistant pneumococcal infections caused by vaccine serotypes. Unvaccinated people of all ages, including babies too young to get the vaccine, have seen decreases in disease.

Rates of invasive pneumococcal disease caused by some serotypes not in PCV7 increased between and However, these increases were small compared to the decreases in serotypes in the vaccine. Also, PCV13 covers the main serotypes that caused the increases. Experts estimate PCV13 prevented more than 30, cases of invasive pneumococcal disease and 3, deaths in its first 3 years of use. A study in the Netherlands included approximately 85, adults 65 years or older.

In this study, PCV13 protected 3 in 4 of those vaccinated against invasive pneumococcal disease caused by vaccine serotypes. PCV13 also protected 9 in 20 vaccinated against pneumococcal pneumonia caused by vaccine serotypes. Studies show PPSV23 protects between 10 to 17 in 20 adults with healthy immune systems against invasive disease caused by vaccine serotypes. Top of Page. Most people who get a pneumococcal vaccine do not have any serious problems with it. With any medicine, including vaccines, there is a chance of side effects.

These are usually mild and go away on their own within a few days, but serious reactions are possible. Young children who get PCV13 at the same time as inactivated flu vaccine may be at increased risk for seizures caused by fever. Ask your doctor for more information. PCV13 is part of the routine childhood immunization schedule. Therefore, it is regularly available for children at:. 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.

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