When was pneumococcal vaccine introduced

Since its licensure, the pneumococcal vaccine has been given to millions of children safely. A second type of pneumococcal vaccine, known as the pneumococcal polysaccharide vaccine, protects against more types of pneumococcus 23 types , but does not include the harmless protein, so it is mostly used only in older adults or those at higher risk for pneumococcus.

After receiving the pneumococcal vaccine, children commonly will have pain or swelling where the shot is given and occasionally low-grade fever. About 1 of every children will develop a high fever. Side effects from the polysaccharide version used in adults include tenderness and redness at the injection site, and about 1 of every people will get a fever and experience muscle aches.

Everyone has heard it on the news — the story of a local student infected with meningitis. Such a report inevitably results in many questions and a great amount of concern and even fear among families with children in the affected school. There are some important considerations when this happens. First, it is important to remember that meningitis refers to an infection that has reached the lining of the brain and spinal cord.

Second, it can be caused by viruses or bacteria hence the reference to viral meningitis or bacterial meningitis. Viral meningitis, the most common type of meningitis, is often less severe than bacterial meningitis. Vaccine-preventable diseases that can cause viral meningitis include measles, mumps , chickenpox and influenza.

Most, but not all, cases of bacterial meningitis can be prevented by vaccination. The bacteria most often associated with meningitis include meningococcus , pneumococcus, and Haemophilus influenzae type B often referred to as Hib.

Fortunately, by the age of 2, most children are fully immunized against pneumococcus and Hib and most adolescents are protected against meningococcus. Pneumococcus is a common cause of ear infections in infants and young children. However, other bacteria also cause ear infections in this age group. The pneumococcal vaccine prevents about 7 of every ear infections and about 20 of every severe ear infections requiring tubes.

The following groups of adults should get both types of the pneumococcal vaccine conjugate and polysaccharide :. The following groups of adults should get the polysaccharide pneumococcal vaccine regardless of age:.

Read a personal story». Pneumococcal bacteria still cause hundreds of cases of meningitis, bloodstream infections and pneumonia every year in the United States.

Because the pneumococcal vaccine does not cause serious side effects, the benefits of the vaccine clearly outweigh its risks. Pneumococcal conjugate vaccine and pneumococcal common protein vaccines and Pneumococcal polysaccharide vaccines in Vaccines, 7th Edition, , Centers of Disease Control and Prevention. Materials in this section are updated as new information and vaccines become available. The Vaccine Education Center staff regularly reviews materials for accuracy.

You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family's personal health. It's also known as the pneumonia vaccine.

Pneumococcal infections are caused by the bacterium Streptococcus pneumoniae and can lead to pneumonia , blood poisoning sepsis and meningitis. Anyone can get a pneumococcal infection. But some people are at higher risk of serious illness, so it's recommended they're given the pneumococcal vaccination on the NHS.

People aged 65 and over only need a single pneumococcal vaccination. This vaccine is not given annually like the flu jab. If you have a long-term health condition you may only need a single, one-off pneumococcal vaccination, or a vaccination every 5 years, depending on your underlying health problem. Find out who should have the pneumococcal vaccine. The type of pneumococcal vaccine you're given depends on your age and health.

There are 2 types. Pneumococcal conjugate vaccine PCV is used to vaccinate children under 2 years old as part of the NHS vaccination schedule.

It's known by the brand name Prevenar Read the patient information leaflet for Prevenar 13 on the electronic medicines compendium website. Pneumococcal polysaccharide vaccine PPV is given to people aged 65 and over and people at high risk because they have long-term health conditions. Read the patient information leaflet for PPV on the electronic medicines compendium website. Children at risk of pneumococcal infections can have the PPV vaccine from the age of 2 years onwards.

The PPV vaccine is not very effective in children under the age of 2. Both types of pneumococcal vaccine encourage your body to produce antibodies against pneumococcal bacteria. Antibodies are proteins produced by the body to neutralise or destroy disease-carrying organisms and toxins. If they are age 65 years or older when first diagnosed, they will need only one dose. Is systemic lupus erythematosus SLE, lupus a risk-based indication for pneumococcal vaccines?

Lupus per se is not an indication for either pneumococcal vaccine. However, immunosuppressive medication that may be used to treat lupus could create an indication for administering both pneumococcal vaccines. Also, if the patient has certain complications of lupus such as nephrotic syndrome , the person would be a candidate for pneumococcal vaccines. A handy document that summarizes indications for both pneumococcal vaccines is available at www. Does her illness fall under the criteria for administering PPSV23?

How often should diabetic patients receive PPSV23? People with either type 1 or type 2 diabetes who are ages 2 through 64 years who have not already received a dose of PPSV23 should receive their first dose now.

At age 65 years they should receive a one-time revaccination if 5 years have elapsed since the previous dose. Diabetes is not an indication for PCV13, however persons 65 years and older may be considered for PCV13 vaccination based on shared clinical decision-making between the provider and patient.

PPSV23 is recommended for people with diabetes. Does this include gestational diabetes? How often should adult dialysis patients receive pneumococcal polysaccharide vaccine? Once they become age 65, they will need another PPSV23 dose. 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.

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