• Pneumococcal Vaccine

    (Pneumococcal Conjugate Vaccine; PCV; Pneumococcal Polysaccharide Vaccine; PPSV)

    What Is Pneumococcal Disease?

    Pneumococcal disease is an infection caused by the bacterium Streptococcus pneumoniae . It can lead to:
    Streptococcus pneumoniae is spread through contact with a person who has the disease or who carries the bacteria in his throat. This most often occurs through droplets from the nose or mouth of someone with the infection.

    What Is the Pneumococcal Vaccine?

    There are two types of pneumococcal vaccines:
    • Pneumococcal conjugate vaccine (PCV)—recommended for infants and toddlers. The PCV13 vaccine, which protects against 13 types of pneumococcal bacteria, replaced the PCV7 vaccine.
    • Pneumococcal polysaccharide vaccine (PPSV)—recommended for certain children and adults
    The vaccines are made from inactivated bacteria. It is given by injection under the skin or into the muscle. The goal of getting a vaccine is that later, when you are exposed to the bacteria, you will not get sick from it.

    Who Should Get Vaccinated and When?

    PCV

    The PCV is routinely given in four doses at 2, 4, 6, and 12-15 months.
    If your child has not been vaccinated or missed a dose, talk to the doctor. Depending on your child's age, he may need additional doses. Also, an additional dose may be needed if your child:
    • Is less than five years old and was given PCV7 (an earlier version of the vaccine)
    • Has an underlying condition that puts him at higher risk for severe disease

    PPSV

    In Children
    If your child is aged 2-18 years old and is at high risk, he may need the PPSV, even if he has received the full series of PCV vaccine. High risk includes:
    Two doses of PPSV may be needed in some cases.
    In Adults
    PPSV is recommended for adults:
    • Aged 65 years and older
    • Aged 64 years and younger who are at high risk, which includes: Having certain conditions, such as:
    • Living in a nursing home or long-term care facility
    • Being a smoker
    • Taking certain medicines (eg, long-term steroids, medicines to treat cancer, radiation therapy) (the vaccine should be given at least 2 weeks before cancer treatment begins)
    In some cases, a second dose of PPSV may be needed. For example, another dose after five years may be needed for people aged 19-64 years who have conditions like chronic renal failure or immunocompromising conditions (eg, HIV/AIDS).

    What Are the Risks Associated With the Pneumococcal Vaccine?

    PCV

    Side effects include redness, tenderness, or swelling at the injection site. Fever is also a risk. There have also been reports of drowsiness and loss of appetite. Generally, all vaccines can have a very small risk of serious problems.
    Acetaminophen (eg, Tylenol) is sometimes given to reduce pain and fever that may occur after getting a vaccine. In infants, the medicine may weaken the vaccine's effectiveness. Discuss the risks and benefits of taking acetaminophen with the doctor.

    PPSV

    Half of the people who get the vaccine have mild side effects. These may include redness or pain at the injection site. Less than 1% will develop a fever, muscle aches, or more severe local reactions. In rare cases, severe allergic reactions and other serious problems occur. However, developing the disease is much more likely to cause serious problems than getting the vaccine.

    Who Should Not Get Vaccinated?

    PCV

    Your child should not receive the PCV if he:
    • Had a life-threatening allergic reaction to a previous dose of PCV
    • Had a severe allergy to one of the vaccine's components
    • Is moderately or severely ill (wait until your child recovers)

    PPSV

    You should not receive the PPSV if you:
    • Had a life-threatening allergic reaction to a previous dose of PPSV
    • Had a severe allergy to one of the vaccine's components
    • Are moderately or severely ill (wait until you recover)

    What Other Ways Can Pneumococcal Disease Be Prevented Besides Vaccination?

    • Avoid close contact with people who have infections.
    • Wash your hands regularly to reduce your risk of infection.

    What Happens in the Event of an Outbreak?

    In the event of an outbreak, all people who are eligible for a vaccine should receive it.

    WHERE CAN I GET MORE INFORMATION?

    FamilyDoctor.org http://familydoctor.org/

    National Immunization ProgramCenters for Disease Control and Prevention http://www.cdc.gov/vaccines/

    References

    Baker CJ, Pickerling LK, Chilton L, et al; Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2011. Ann Intern Med . 1 Feb 2011. 154(3):168-173.

    Centers for Disease Control and Prevention. Pneumococcal conjugate vaccine. Centers for Disease and Control and Prevention website. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-pcv.pdf . Update April 16, 2010. Accessed January 7, 2011.

    Centers for Disease Control and Prevention (CDC). Pneumococcal polysaccharide vaccine. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-ppv.pdf . Updated October 2009. Accessed January 7, 2011.

    Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years —United States, 2011. MMWR 2011;60(5).

    National Immunization Program. United States Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/nip .

    Parents’ guide to childhood immunization. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/vpd-vac/pneumo/downloads/pg%5Fwhy%5Fvacc%5Fpneumo.pdf . Accessed February 18, 2008.

    Pneumococcal: understanding the disease. National Network for Immunization Information website. Available at: http://www.immunizationinfo.org/vaccines/pneumococcal-disease . Updated March 31, 2010. Accessed January 7, 2011.

    Recommended adult immunization schedule—United States, 2012. MMWR Morb Mortal Wkly Rep . 2012;6(4). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/recs/schedules/downloads/adult/mmwr-adult-schedule.pdf . Accessed February 17, 2012.

    Vaccine information for the public and health professionals—pneumoccocal vaccine: questions and answers. Immunization Action Coalition website. Available at: http://www.vaccineinformation.org/pneumchild/qandavax.asp . Accessed February 18, 2008.

    Vaccine information statement: pneumococcal conjugate vaccine. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-pcv.pdf . Updated April 16, 2010. Accessed February 10, 2012.

    1/31/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years—United States, 2008. MMWR. 2008;57;Q1-Q4. Centers for Disease Control and Prevention, MMWR website. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5701a8.htm . Updated January 10, 2008. Accessed January 28, 2008.

    10/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Prymula R, Siegrist C, Chlibek R, et al. Effect of prophylactic paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: two open-label, randomised controlled trials. Lancet . 2009;374(9698):1339.

    9/17/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Centers for Disease Control and Prevention. Updated recommendations for prevention of invasive pneumococcal disease among adults using the 23-valent pneumococcal polysaccharide vaccine (PPSV23). MMWR Morb Mortal Wkly Rep. 2010;59(34):1102-1106.

    1/7/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Nuorti J, Whitney C, Centers for Disease Control and Prevention (CDC). Prevention of pneumococcal disease among infants and children—use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine. MMWR Morb Mortal Wkly Rep . 2010;59(34):1102. Centers for Disease Control and Prevention (CDC); Advisory Committee on Immunization Practices. Updated recommendations for prevention of invasive pneumococcal disease among adults using the 23-valent pneumococcal polysaccharide vaccine (PPSV23). MMWR Morb Mortal Wkly Rep. 2010;59(34):1102-1106. Centers for Disease Control and Prevention (CDC); Advisory Committee on Immunization Practices. Licensure of a 13-Valent pneumococcal conjugate vaccine (PCV13) and recommendations for use among children. MMWR Recomm Rep . 2010;59(RR-11):1.

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