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Pneumococcal Vaccination (cont.)

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What if it is not clear what a person's vaccination history is?

When indicated, vaccine should be administered to patients with unknown vaccination status. All residents of nursing homes and other long-term care facilities should have their vaccination status assessed and documented.

How long must a person wait to receive other vaccinations?

Inactivated influenza vaccine and tetanus vaccines may be given at the same time as or at any time before or after a dose of pneumococcus vaccine. There are no requirements to wait between the doses of these or any other inactivated vaccines.

Vaccination of children recommended

In July 2000, the American Academy of Pediatrics (AAP) and the CDC jointly recommended childhood pneumococcal immunization, since pneumococcal infections are the most common invasive bacterial infections in children in the United States.

"The pneumococcal conjugate vaccine, PCV13 or Prevnar 13, is currently recommended for all children younger than 5 years of age, all adults 65 years or older, and persons 6 through 64 years of age with certain medical conditions," according to the 2014 AAP/CDC guidelines. "Pneumovax is a 23-valent pneumococcal polysaccharide vaccine (PPSV23) that is currently recommended for use in all adults 65 years of age or older and for persons who are 2 years and older and at high risk for pneumococcal disease (e.g., those with sickle cell disease, HIV infection, or other immunocompromising conditions). PPSV23 is also recommended for use in adults 19 through 64 years of age who smoke cigarettes or who have asthma."

What are the current recommendations for administration of pneumococcal vaccine in healthy adults?

Patients who are healthy and have never received the pneumococcal pneumonia vaccine (PPSV23), if equal to or older than 65 years of age, should receive the PCV13 first and then within six months to a one year receive the PPSV23. Those who have already received the PPSV23, should get the PCV13 about one year later. If the person received the PPSV23 over five years earlier, they essentially should be treated as if they never received the vaccine, getting the PCV13 injection, followed about six to 13 months later by the PPSV23. In general, there seems to be a better immune response to the overlapping 13 strains of pneumococcus if the PCV13 is received first. The adverse effects are similar and minimal, mainly soreness at the injection site, fatigue, headache, chills, and diffuse achiness.


United States. Centers for Disease Control and Prevention. "Licensure of a 13-Valent Pneumococcal Conjugate Vaccine (PCV13) and Recommendations for Use Among Children --- Advisory Committee on Immunization Practices (ACIP), 2010." MMWR 59.09 Mar. 12, 2010: 258-261.

United States. Centers for Disease Control and Prevention. "Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine Among Adults Aged > or Equal to 65 Years: Recommendations of the Advisory Committee on Immunization Practices (ACIP)." MMWR 63.37 Sept. 19, 2014: 822-825.

Last Editorial Review: 10/26/2015


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