Adult Dosing
Pneumococcal immunization
- Administer 0.5 mL as a single dose IM or SC into the deltoid muscle or lateral mid-thigh
Notes:- Administer at least 2 wks prior to elective splenectomy or immunosuppressive therapy
- Routine revaccination of immunocompetent persons is not indicated; revaccinate if at highest risk of serious pnuemococcal infections and if rapid decline in pneumococcal antibodies
- Revaccinate after 5 yrs in high risk patients; if the patient was vaccinated before age 65, give again after 65 years of age if 5 yrs have passed
- Do not mix with other vaccines in the same syringe or vial
Pediatric Dosing
Pneumococcal immunization
- Safety and effectiveness in pediatric patients <2 years have not been established
Children >2 years
- Administer 0.5 mL as a single dose IM or SC into the deltoid muscle or lateral mid-thigh
Notes:- Administer at least 2 wks prior to elective splenectomy or immunosuppressive therapy
- Routine revaccination of immunocompetent persons is not indicated; revaccinate if at highest risk of serious pnuemococcal infections and if rapid decline in pneumococcal antibodies
- Revaccinate children with nephrotic syndrome, asplenia, or sickle-cell anemia in 3-5 yrs if <10 yrs of age or in 5 yrs if >10 yrs of age
- Do not mix with other vaccines in the same syringe or vial
[Outline]
- Recommended only for IM/SC administration; do not inject intradermally or intravascularly
- Use cautiously in patients with severely compromised cardiovascular and/or pulmonary function in whom a systemic reaction would pose a significant risk
- Delay administration of vaccine in case of moderate or severe acute illness, febrile respiratory illness, or other active infections except when, in the opinion of the physician, withholding the agent entails even greater risk
- Vaccine does not replace the need for penicillin or other antibiotic prophylaxis against pneumococcal infection; do not discontinue such prophylaxis after vaccination with pneumococcal polyvalent-23 vaccine in patients who require antibiotic prophylaxis
- Vaccine may not be effective in preventing pneumococcal meningitis in patients with CSF leakage due to congenital lesions, skull fractures, or neurosurgical procedures
- Individuals who are immunocompromised such as those receiving immunosuppressive therapy may have a diminished immune response to pneumococcal polyvalent-23 vaccine
- Routine revaccination of immunocompetent persons previously vaccinated with a pneumococcal polyvalent-23 vaccine is not recommended. However, revaccination once is recommended for patients who received vaccine 5 or more years earlier if they are at highest risk for serious pneumococcal infections and in those who are likely to have a rapid decline in pneumococcal antibody levels
Cautions: Use cautiously in
- Active infections
- Concurrent cancer chemotherapy
- Radiation therapy
- Concurrent immunosuppressants
Pregnancy Category:C
Breastfeeding: As per the Centers for Disease Control and Prevention and several health professional organizations, the vaccines administered to a nursing mother do not affect the safety of breastfeeding for mothers or infants and breastfeeding is not a contraindication to pneumococcal vaccine. Breastfed infants should be vaccinated according to the routine recommended schedules. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 24 August 2011). Manufacturer advises caution.
2 years who are at increased risk for pneumococcal disease or living in special environments/social settings
