Dtap And Tdap Immunization Schedules
The first DTaP immunizations start when children are very young. DTaP shots for young children are typically given at:
- 6 weeks to 2 months
- 4 months
- 4 to 6 years
Thereafter, Tdap booster shots are given to ensure lasting protection against tetanus, diphtheria, and pertussis.
Adolescents are advised to get a booster Tdap shot at around 11 to 12 years. If they miss this, it is OK for them to get a Tdap between 13 and 18 years.
It is recommended that adults get a Tdap shot for one of their tetanus boosters. If youre 65 and over, Tdap vaccination is also recommended.
How Should I Use This Medicine
This vaccine is for injection into a muscle or under the skin. It is given by a health care professional.
A copy of Vaccine Information Statements will be given before each vaccination. Read this sheet carefully each time. The sheet may change frequently.
Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children as young as 2 years of age for selected conditions, precautions do apply.
Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.
Pneumococcal Vaccine For Babies
All babies are offered pneumococcal immunisation as part of the NHS childhood immunisation schedule.
They’ve 3 doses, which are given:
- at 8 weeks
- at 16 weeks
- between 12 and 13 months of age
The pneumococcal vaccine for babies is entirely safe, although around one baby in 10 will have some redness and swelling at the site of the injection, and symptoms of a mild fever. However, these side effects will pass quickly.
Speak to your GP or health visitor if you are not sure whether your child has received their pneumococcal immunisation.
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How The Pneumococcal Vaccine Works
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.
They protect you from becoming ill if you’re infected with the bacteria.
More than 90 different strains of the pneumococcal bacterium have been identified, although most of these strains do not cause serious infections.
The childhood vaccine protects against 13 strains of the pneumococcal bacterium, while the adult vaccine protects against 23 strains.
Age Recommendations And Dosing
Prevnar 13 is approved for use in children 6 weeks and older, and the CDC recommends it for children younger than 2 years old and people 2 years or older with certain medical conditions. Its given into the muscle, and its a 4-dose series for children between 2 and 15 months of age. For children who dont receive the vaccine at this time, a catch-up schedule is available.
Prevnar 20 is currently approved for use in adults at least 18 years old, but official CDC recommendations havent been established yet. Its given as a single-dose injection into the muscle.
Pneumovax 23 is approved for use in children 2 years and older at higher risk of infection and adults at least 50 years old. However, the CDC recommends it for all adults 65 years or older, people 2 through 64 years with certain medical conditions, and adults 19 through 64 years who smoke cigarettes. Its a single-dose injection given into the muscle or skin, but additional doses may be recommended for some people.
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Side Effects Of The Vaccines Against Pneumococcal Disease
Vaccines against pneumococcal disease are effective and safe, although all medications can have unwanted side effects.
Side effects from the vaccine are uncommon and usually mild, but may include:
- localised pain, redness and swelling at the injection site
- occasionally, an injection-site lump that may last many weeks
- low-grade temperature .
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Who Should Get The Pneumococcal Vaccine And When Should It Be Given
The PCV7 vaccine that covered seven strains of pneumococcal bacteria, has now been updated to the PCV13 vaccine, which covers 13 strains. A PCV series begun with PCV7 should be completed with PCV13. A single additional dose of PCV13 is recommended for all children 14â59 months who have received an age-appropriate series of PCV7 and for all children 60â71 months with underlying specific medical conditions who have received an age-appropriate series of PCV7.
The PCV vaccine is recommended for the following children:
- All infants younger than 24 months should receive four doses of the vaccine, the first one at 2 months. The next two shots should be given at 4 months and 6 months, with a final booster that should be given at 12 to 15 months. Children who do not get their shot at these times should still get the vaccine. The number of doses and time between doses will depend on the child’s age.
- Healthy children ages 2 through 4 years who did not complete the four doses should receive one dose of the vaccine.
The PPSV vaccine is recommended for any adult ages 19 through 64 who smokes or has asthma and anyone ages 2 through 64 who is taking a drug or treatment that affects the body’s immune system. Examples would be long-term use of steroids, chemotherapy, or radiation therapy.
In addition, anyone ages 2 through 64 who has one of the following health conditions that affect the immune system should be vaccinated with PPSV:
- leaks of cerebrospinal fluid
- cochlear implant
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What Are The Side Effects
Vaccines are very safe. It is much safer to get the vaccine than to get pneumococcal disease.
Many people have no side effects from the vaccines. For those that do, side effects are usually mild and last 1 to 2 days . Serious side effects are very rare.
It is important to stay in the clinic for 15 minutes after getting any vaccine because there is a very rare possibility, between one in 100,000 and one in a million, of a life-threatening allergic reaction called anaphylaxis. This may include hives, difficulty breathing, or swelling of the throat, tongue or lips. Should this reaction occur, your health care provider is prepared to treat it. Emergency treatment includes injection of epinephrine and transfer by ambulance to the nearest emergency department. If symptoms develop after you leave the clinic, call 9-1-1 or the local emergency number.
It is important to always report serious or unexpected reactions to your immunizing health care provider.
A Look At Each Vaccine: Pneumococcal Vaccine
Much like Haemophilus influenzae type b , pneumococcal bacteria affect the most defenseless of the population . The diseases caused by pneumococcus include meningitis , bloodstream infections and pneumonia . The pneumococcal vaccine was first introduced for use in all infants in the United States in 2000. Before the vaccine, every year pneumococcus caused about 700 cases of meningitis, 17,000 cases of bloodstream infections, 200 deaths and 5 million ear infections in children.
Infants and young children are at greatest risk of serious infection because they are unable to develop immunity to the sugar that coats the bacteria, something that older children can do when they are more than 2 years of age.
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Who Shouldnt Get Prevnar 20
People who have had a severe allergic reaction in the past to any of the vaccines ingredients including diphtheria protein should not receive Prevnar 20. People who are 17 years or younger also shouldnt receive this vaccine.
At this time, the FDA didnt place any other restrictions on who can receive Prevnar 20. If youre unsure if you should receive this vaccine, your healthcare provider can give you more information.
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How Long Does A Pneumonia Shot Last
Streptococcus pneumoniaevaccinepneumoniaStreptococcus pneumoniae
- Younger than 2 years old: four shots
- 65 years old or older: two shots, which will last you the rest of your life
- Between 2 and 64 years old: between one and three shots if you have certain immune system disorders or if youre a smoker
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Pneumococcal Disease Vaccine For Children
The risk of infection in young children, especially those under two years of age, can be substantially reduced with a vaccine called Prevenar 13. Under the National Immunisation Program Schedule, this vaccine is free for all infants at two, four and 12 months of age. Extra pneumococcal vaccine is given to children with certain medical risk factors at six months and four to five years of age.
When To Seek Emergency Medical Advice
The most serious type of pneumococcal infection is bacterial meningitis, which requires immediate admission to hospital for emergency treatment.
Bacterial meningitis has a number of early warning signs that can occur earlier than the other symptoms.
- pain in the muscles, joints or limbs such as in the legs or hands
- shivering or unusually cold hands and feet
- blue lips and pale or blotchy skin
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Is It True That More Than One Type Of Infection Can Cause Meningitis
Yes. 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 .
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 . Fortunately, by the age of 2, most children are fully immunized against pneumococcus and Hib and most adolescents are protected against meningococcus.
Risk Of Pneumococcal Disease
Certain groups are at increased risk of infection, including:
- children aged under two years
- children under five years with underlying medical conditions predisposing them to invasive pneumococcal disease
- Aboriginal and Torres Strait Islander children, especially in central Australia
- Aboriginal and Torres Strait Islander people
- people aged 65 years and over
- people with weakened immune systems
- people with chronic diseases such as diabetes, lung disease, cancer or kidney disease
- people who have impaired spleen function or have had their spleen removed
- people who smoke tobacco.
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Pneumococcal Infections After Influenza
Pneumococcus is known as an opportunistic infection because it lives in the respiratory tract of people without causing disease, but when the respiratory tract is compromised by an infection such as influenza, the bacteria then invades the lungs , bloodstream , or brain and spinal cord . Activities like smoking can also disrupt the lining of the nose and throat and allow for pneumococcal infections and subsequent disease.
Concerns About Immunisation Side Effects
If the side effect following immunisation is unexpected, persistent or severe or if you are worried about yourself or your childs condition after a vaccination, see your doctor or immunisation nurse as soon as possible or go directly to a hospital. Immunisation side effects may be reported to SAEFVIC, the Victorian vaccine safety service.
It is also important to seek medical advice if you are unwell, as this may be due to other illness rather than because of the vaccination.
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Medical Conditions Resulting In High Risk Of Ipd
Table 1: Medical Conditions Resulting in High risk of IPD
IPD is more common in the winter and spring in temperate climates.
Spectrum of clinical illness
Although asymptomatic upper respiratory tract colonization is common, infection with S. pneumoniae may result in severe disease. IPD is a severe form of infection that occurs when S. pneumoniae invades normally sterile sites, such as the bloodstream or central nervous system. Bacteremia and meningitis are the most common manifestations of IPD in children 2 years of age and younger. Bacteremic pneumococcal pneumonia is the most common presentation among adults and is a common complication following influenza. The case fatality rate of bacteremic pneumococcal pneumonia is 5% to 7% and is higher among elderly persons. Bacterial spread within the respiratory tract may result in AOM, sinusitis or recurrent bronchitis.
Worldwide, pneumococcal disease is a major cause of morbidity and mortality. The World Health Organization estimates that almost 500,000 deaths among children aged less than 5 years are attributable to pneumococcal disease each year. In Canada, IPD is most common among the very young and adults over 65 years of age.
Medicare Coverage For The Pneumonia Shot
Part B of Original Medicare does cover the pneumonia vaccine, but there are certain limitations, according to Medicare.gov:
- Medicare Part B covers one shot. Anybody who is enrolled in Part B is entitled to a dose of pneumonia vaccine without having to pay for it if your health-care provider accepts Medicare assignment.
- Under certain circumstances, a doctor may prescribe a second shot of a different typeat least one year after the first dose. Part B may also cover this second dose.
- In either situation described above, you typically wont have out-of-pocket costs as a Part B beneficiary.
In some cases, a doctor may recommend more doses than the amount that Part B pays for. For example, a doctor may suggest a second dose of the PPSV23 vaccine. In this case, its possible that a Medicare Supplement or Medicare Advantage plan will provide coverage. Otherwise, you might have to pay for these additional services out of pocket. If the cost is a concern, its a good idea to contact Medicare or your Medicare plan to learn how these additional services will be covered or if they will be covered at all.
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Are Both Pneumococcal Vaccines Safe
Both vaccines are safe. As with any medicine there is always the possibility of a serious problem, such as an allergic reaction. But with PCV and PPSV , the risk of serious harm or death is extremely small.
In studies involving nearly 60,000 doses of the PCV vaccine, there have been no moderate or severe reactions. The mild side effects included:
- Redness, tenderness, or swelling where the shot is given in about one out of every four infants
- Fever higher than 100.4 F in about one out of every three infants
- Fever higher than 102.2 F in about one out of every 50 children
- Occasional incidence of fussiness, drowsiness, or loss of appetite
About one out of every two adults who receive the PPSV vaccine experiences redness or pain where the shot is given. Less than 1% have a more severe reaction, such as a fever or muscle aches.
How Do I We Get The Vaccine
In Canada, all provinces and territories provide the pneumococcal conjugate vaccine, starting at 2 months of age. While the exact schedule will depend on where you live, usually two shots are given between 2 and 11 months of age and a booster at 12-15 months. Children at high risk of disease are given three shots , as well as the booster.
Unvaccinated children between 15 months and 5 years old should also get the vaccine. Your doctor or public health unit can tell you the number of shots your child will need and when.
All unvaccinated children and adolescents who are at high risk of serious infection should receive both the conjugate and the polysaccharide vaccine. The polysaccharide vaccine is at given at age 2 or later, with a booster 5 years after the first.
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Who Should Get Vaccinated Against It
Three vaccines are now available to help prevent pneumococcal disease. Before the FDA approval of Prevnar 20, the Centers for Disease Control and Prevention recommended the use of two other pneumococcal vaccines and . You can read more about them here.
The CDC recommends pneumococcal vaccination for all children under 2 years old and all adults at least 65 years old. Although pneumococcal disease can affect people of all ages, younger children and older adults are most at risk.
Depending on vaccination history and the presence of certain medical conditions, other people may also need to receive pneumococcal vaccinations. If you arent sure of your pneumococcal vaccination history, speak to your healthcare provider.
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Children At High Risk Of Ipd
Infants at high risk of IPD due to an underlying medical condition should receive Pneu-C-13 vaccine in a 4 dose schedule at 2 months, 4 months and 6 months followed by a dose at 12 to 15 months of age. Table 3 summarizes the recommended schedules for Pneu-C-13 vaccine for infants and children at high risk of IPD due to an underlying medical condition by pneumococcal conjugate vaccination history.
In addition to Pneu-C-13 vaccine, children at high risk of IPD due to an underlying medical condition should receive 1 dose of Pneu-P-23 vaccine at 24 months of age, at least 8 weeks after Pneu-C-13 vaccine. If an older child or adolescent at high risk of IPD due to an underlying medical condition has not previously received Pneu-P-23 vaccine, 1 dose of Pneu-P-23 vaccine should be administered, at least 8 weeks after Pneu-C-13 vaccine. Children and adolescents at highest risk of IPD should receive 1 booster dose of Pneu-P-23 vaccine refer to Booster doses and re-immunization. Refer to Immunocompromised persons for information about immunization of HSCT recipients.
Table 3: Recommended Schedules for Pneu-C-13 Vaccine for Children 2 months to less than 18 years of age, by Pneumococcal Conjugate Vaccination History
|Age at presentation for immunization||Number of doses of Pneu-C-7, Pneu-C-10 or Pneu-C-13 previously received|
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