How Many Doses Of Pneumococcal Vaccine For Adults

Why It Is Used

Pneumococcus is a type of bacteria that can cause severe infections, such as pneumonia, meningitis, and blood infections . These infections can be serious and can even cause death, especially in people who have impaired immune systems, older adults, and children younger than 2 years of age.

Doctors use two types of pneumococcal vaccines for routine immunization: pneumococcal conjugate or pneumococcal polysaccharide . The type of vaccine used depends on a person’s age.

• Pneumococcal conjugate
• PCV is recommended for routine use in babies who get 3 or 4 doses depending on your provincial recommendations.
• Children from 1 to 18 years old may be recommended to get an extra dose if they did not get all the doses as a baby. They may also need an extra dose if they have certain medical conditions that place them at high risk for infection with pneumococcus.
• The vaccine may be recommended for adults at high risk for infection with pneumococcus. This recommendation depends on the medical condition the adult has and on provincial recommendations.

How Many Doses Of Ppsv23 Can An Adult Get In A Lifetime Who/when

CDC recommends some adults receive up to 3 doses of PPSV23 in a lifetime. Adults who have immunocompromising conditions should receive two doses of PPSV23, given 5 years apart, before age 65 years. Those adults should then receive a third dose of PPSV23 at or after 65 years, as long as its been at least 5 years since the most recent dose.

Global Burden Of Disease

Pneumococcal disease is a common cause of morbidity and mortality worldwide. Rates of disease and death are highest in low-income countries with the majority of deaths occurring in sub-Saharan Africa and Asia. Along with the very old and very young, patients with underlying cardiorespiratory disease and congenital or acquired immunosuppression have the highest rates of disease.

Risk of disease increases with multiple comorbidities and lifestyle factors . The risk of IPD in children and adults with two or more comorbid conditions can be as high as in those with a recognised high-risk condition. Lifestyle factors, such as passive smoking, environmental and workplace pollutions, smoking and alcohol dependency, can increase the risk of severe pneumococcal disease, especially in those with chronic illnesses that predispose them to infection, such as asthma, diabetes, dementia and mental illness. Socioeconomic deprivation, homelessness and overcrowding have also been associated with increased risk of IPD.

In each geographical region globally, PCV10 and PCV13 were shown to cover more than 70 percent of the serotypes causing IPD under 5 years of age during 19802007 prior to PCV introduction .

You May Like: Does Cvs Offer Tetanus Shots

Acip Guidelines Aged 6

Any of the following conditions:

Cerebrospinal fluid leak

Sickle cell disease and other hemoglobinopathies

Anatomic or functional asplenia

Chronic renal failure

Nephrotic syndrome

Diseases associated with immunosuppressive drugs or radiation therapy, including malignant neoplasms, leukemias, lymphomas, and Hodgkin disease generalized malignancy solid organ transplantation or multiple myeloma

1. If neither PCV13 nor PPSV23 has been received previously, administer 1 dose of PCV13 now and 1 dose of PPSV23 at least 8 wk later

2. If PCV13 has been received previously but PPSV23 has not, administer 1 dose of PPSV23 at least 8 wk after the most recent dose of PCV13

3. If PPSV23 has been received but PCV13 has not, administer 1 dose of PCV13 at least 8 wk after the most recent dose of PPSV23

Heart, lung, diabetes, liver diseases in 6-18 year olds

• Chronic heart disease
• Chronic lung disease
• Diabetes mellitus
• Chronic liver disease
• If the patient has not received PPSV23, administer 1 dose of PPSV23
• If PCV13 has been received previously, then PPSV23 should be administered at least 8 wk after any prior PCV13 dose

Concurrent Administration Of Vaccines

Pneumococcal vaccines may be administered concomitantly with other vaccines, with the exception of a different formulation of pneumococcal vaccine . There should be at least an 8 week interval between a dose of pneumococcal conjugate vaccine and a subsequent dose of Pneu-P-23 vaccine, and at least a 1 year interval between a dose of Pneu-P-23 vaccine and a subsequent dose of pneumococcal conjugate vaccine refer to Immunocompromised persons for information regarding administration of pneumococcal vaccines to HSCT recipients. Different injection sites and separate needles and syringes must be used for concurrent parenteral injections. Refer to Timing of Vaccine Administration in Part 1 for additional information about concurrent administration of vaccines.

Also Check: Does Cvs Give Tetanus Shots

Recommendations For Adults With Previous Ppsv23 Vaccinations

Adults 65 years of age or older who do not have an immunocompromising condition, cochlear implant, or cerebrospinal fluid leak and who have not previously received PCV13 may receive a dose of PCV13. Based on , clinicians and these older adults can discuss PCV13 vaccination to decide if it is appropriate. For those who choose to receive PCV13, give the dose of PCV13 at least 1 year after the most recent PPSV23 dose. Additionally, all adults 65 years or older should receive 1 dose of PPSV23 after age 65 years old regardless of their previous PPSV23 vaccination history. Doses of PPSV23 should be spaced 5 years apart from each other.

Adults 19 years of age or older who previously received one or more doses of PPSV23 should receive a dose of PCV13 at least one year after administration of the most recent PPSV23 dose if they have

• Immunocompromising conditions
• CSF leaks
• Cochlear implants

For those who require an additional dose of PPSV23, administer it no sooner than 8 weeks after PCV13 and at least 5 years after the most recent dose of PPSV23.

Pneumococcal Vaccine Timing for Adults pdf icon provides a summary of this detailed guidance.

Who Should Not Get The Pneumococcal Vaccine Or Should Wait To Get It

• You should not get the vaccine if you have had an allergic reaction to it or to a vaccine for diphtheria, such as DTaP, Tdap, or Td. Tell your healthcare provider if you had an allergic reaction to any other vaccine. Also tell your provider if you have any severe allergies.
• You should wait to get the vaccine if you are sick or have a fever.
• You may need to wait to get the vaccine if you are a pregnant woman. If possible, get the vaccine before you become pregnant. Talk to your healthcare provider about the risks of this vaccine. Your provider can tell you if you are at high risk for pneumococcal infection and when to get the vaccine if you are already pregnant.

Also Check: Tdap Shot At Cvs

How The Vaccine Is Given

• Before you are given the vaccine, ask to read the manufacturer’s printed information leaflet. The manufacturer’s leaflet will give you more information about the vaccine and will tell you about any side-effects which you may experience from having it. If you have any questions about the vaccine, ask your doctor or nurse for advice.
• You will be given one dose of the vaccine. It may be given at the same time as some other vaccines, such as the flu vaccine, but it will be given as a separate injection.
• Most adults over 65 will be given a single, one-off dose of pneumococcal vaccine. Some people with kidney problems or immune system problems may need a ‘booster’ dose every five years. Your doctor will advise you on this.
• The vaccine is given by injection into a muscle, or as an injection underneath your skin.

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.

Read Also: Tdap Cvs

Adults At High Risk Of Ipd

Adults with immunocompromising conditions resulting in high risk of IPD, except HSCT, should receive 1 dose of Pneu-C-13 vaccine followed at least 8 weeks later by 1 dose of Pneu-P-23 vaccine, if not previously received. The dose of Pneu-C-13 vaccine should be administered at least 1 year after any previous dose of Pneu-P-23 vaccine. Refer to Immunocompromised persons for information about immunization of HSCT recipients.

Immunocompetent adults with conditions or lifestyle factors resulting in high risk of IPD should receive 1 dose of Pneu-P-23 vaccine, if not previously received. One dose of Pneu-P-23 vaccine is also recommended for all adults who are residents of long-term care facilities and should be considered for individuals who use illicit drugs.

Some experts also suggest a dose of Pneu-C-13 vaccine, followed by Pneu-P-23 vaccine, for immunocompetent adults with conditions resulting in high risk of IPD as this may theoretically improve antibody response and immunologic memory. However, Pneu-P-23 vaccine is the vaccine of choice for these individuals, and if only one vaccine can be provided, it should be Pneu-P-23 vaccine, because of the greater number of serotypes included in the vaccine.

Adults at highest risk of IPD should also receive 1 booster dose of Pneu-P-23 vaccine refer to Booster doses and re-immunization.

Table 4 – provides recommended schedules for adult immunization with pneumococcal vaccines.

Where Can I Find These Vaccines

Your doctors office is usually the best place to receive recommended vaccines for you or your child.

PCV13 is part of the routine childhood immunization schedule. Therefore, it is regularly available for children at:

• Pediatric and family practice offices
• Community health clinics

If your doctor does not have pneumococcal vaccines for adults, ask for a referral.

Pneumococcal vaccines may also be available for adults at:

• Pharmacies
• Health departments
• Other community locations, such as schools and religious centers

Federally funded health centers can also provide services if you do not have a regular source of health care. Locate one near youexternal icon. You can also contact your state health department to learn more about where to get pneumococcal vaccines in your community.

When receiving any vaccine, ask the provider to record the vaccine in the state or local registry, if available. This helps doctors at future encounters know what vaccines you or your child have already received.

You May Like: Tdap Vaccine At Cvs

Recommended But Not Funded

Risk stacking

Two classifications of IPD risk are recognised: high-risk conditions for which there is significant risk of IPD and atrisk conditions, which on their own may not significantly increase risk, but when combined together or with lifestyle risk factors increase an individuals risk of IPD. This is described as risk stacking IPD incidence substantially increases with the accumulation of concurrent risk factors or conditions. The risk of pneumococcal infections in those with two or more at-risk conditions may be as high as the risk for those with a recognised high-risk condition.

Recommendations

PCV13 and 23PPV are recommended but not funded for the following individuals:

• immune-competent adults at increased risk of pneumococcal disease or its complications because of chronic illness
• adults with cerebrospinal uid leak
• immunocompromised adults at increased risk of pneumococcal disease
• individuals of any age who have had one episode of IPD
• smokers.

For those individuals who choose to purchase PCV13 and 23PPV vaccines, providers may follow the age-appropriate schedules in Table 16.4 and Table 16.5.

Adults aged 65 years and older with no other risk factors

Give one dose of PCV13 followed at least eight weeks later with 23PPV .

Acip Guidelines Aged 2

Any of the following conditions:

Chronic heart disease

Chronic lung disease

Diabetes mellitus Cerebrospinal fluid leak

Cochlear implant

Sickle cell disease and other hemoglobinopathies

Anatomic or functional asplenia

Chronic renal failure

Nephrotic syndrome

Diseases associated with immunosuppressive drugs or radiation therapy, including malignant neoplasms, leukemias, lymphomas, and Hodgkin disease solid organ transplantation or congenital immunodeficiency

Dosage for high risk 2-5 years olds

• 1. Administer 1 dose of PCV13 if 3 doses of PCV were received previously
• 2. Administer 2 doses of PCV at least 8 weeks apart if fewer than 3 doses of PCV13 were received previously
• 3. Administer 1 supplemental dose of PCV13 if 4 doses of PCV7 or other age-appropriate complete PCV7 series was received previously
• 4. The minimum interval between doses of PCV is 8 wk
• 5. For children with no history of PPSV23 vaccination, administer PPSV23 at least 8 wk after the most recent dose of PCV13

You May Like: Can You Get Tdap At Cvs

Before Having Pneumococcal Vaccine

Before you are given pneumococcal vaccine, make sure your doctor knows:

• If you have been unwell recently, or if you have a high temperature .
• If you have previously had an allergic reaction to a vaccine or to any other medicine.
• If you have a condition that makes you bleed more than is normal, such as haemophilia.
• If you have a weakened immune system. This may be a result of an illness or taking medicines.
• If you are pregnant or breastfeeding.
• If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

What Is The Pneumococcal Vaccine

The pneumococcal vaccine is an injection given to protect you from pneumococcal disease. Pneumococcal disease develops from an infection caused by pneumococcal bacteria. The infection may cause pneumonia or an ear infection. Pneumococcal disease is spread from person to person through coughing and sneezing. The vaccine comes in 2 forms, called pneumococcal conjugate vaccine and pneumococcal polysaccharide vaccine .

Don’t Miss: Does Cvs Pharmacy Give Tdap Vaccine

Pneumococcal Vaccine Side Effects

Pneumococcal vaccination can have some side effects. Some of the common pneumonia vaccine side effects are:

In adults, after receiving the Pneumococcal vaccination, they may experience

• fatigue,
• injection site reactions like redness, swelling, pain, tenderness, or a hard lump
• limitation of arm movement,
• sleeping more or less than usual,
• Chills,
• low grade fever .
• In infants and toddlers, common side effects of the pneumonia vaccine include the above, and:
• crying,

Who Should Get The Pneumococcal Vaccine

• Adults aged 65 years or older may only need 1 dose. Another dose of either vaccine may be given, if they are at least 1 year apart. Your healthcare provider will tell you if you need more vaccine doses and when to get them.
• Adults aged 19 to 64 at high risk for pneumococcal disease will need 1 or more doses of the vaccine. If you are Native Alaskan or American Indian, ask your healthcare provider if you need the vaccine. Any of the following can increase your risk for pneumococcal disease:
• A chronic heart or lung disease, or diabetes
• Liver disease or alcoholism
• A cerebrospinal fluid leak or cochlear implant
• A damaged or removed spleen, or sickle cell disease
• A weak immune system, HIV, cancer, kidney failure, or an organ transplant
• Living in a nursing home or long-term care facility

Don’t Miss: Tdap Shot Cvs

Side Effects Of The Pneumococcal Vaccine

Like most vaccines, the childhood and adult versions of the pneumococcal vaccine can sometimes cause mild side effects.

These include:

• redness where the injection was given
• hardness or swelling where the injection was given

There are no serious side effects listed for either the childhood or adult versions of the vaccine, apart from an extremely rare risk of a severe allergic reaction .

Administration Of Pneumococcal Vaccine

The usual dose is 0.5 mL IM for PCV13 and 0.5 mL IM or subcutaneous for PCSV23.

PCV13 is recommended as a 4-dose IM series for infants at age 2, 4, 6, and 12 to 15 months. Children aged 7 to 59 months who have not been vaccinated with PCV7 or PCV13 previously should be given 1 to 3 doses of PCV13, depending on their age at the initiation of the vaccination series and the presence of medical conditions. Children aged 24 to 71 months with chronic medical conditions that increase their risk of pneumococcal disease and who have received 3 doses of PCV13 should be given 1 dose of PCV13 at least 8 weeks after the most recent dose if they received less than 3 doses of PCV13, they should be given 2 doses of PCV13 at least 8 weeks apart. Interruption of the vaccination schedule does not require starting the entire series over or giving extra doses.

Children at high risk of pneumococcal disease should be given a dose of PPSV23 at age 24 months at least 8 weeks after the most recent dose of PCV13.

Children aged 14 to 59 months who have received a complete age-appropriate series of PCV7 should be given a single supplemental dose of PCV13.

Adults 65 years with no medical conditions listed above should be given PCV13 first, followed by PPSV23 at least 1 year later. If people have already been vaccinated with PPSV23, PCV13 should be given at least 1 year after the most recent dose of PPSV23.

You May Like: Does Cvs Do Tdap Shots

Aboriginal And Torres Strait Islander People

In addition to the 3 doses for all children < 5 years of age, Aboriginal and Torres Strait Islander children living in the following states and territories are recommended to receive an additional dose of 13vPCV at 6 months of age:

• Northern Territory

This is because of the higher risk of pneumococcal disease in these children.1

These children are also recommended to receive 2 doses of 23vPPV

• 1 dose at 4 years of age
• a 2nd dose at least 5 years later

This is because a considerable proportion of pneumococcal disease in these children is caused by serotypes that are present in 23vPPV13vPCV.

For children aged > 12 months who have not completed a full course of pneumococcal conjugate vaccines, the timing and number of further doses for catch-up vaccination depends on:

• the childs age
• any previous doses they received

Aboriginal and Torres Strait Islander adults without risk conditions for pneumococcal disease are recommended to receive:

• a dose of
• at least 5 years later

This is based on:

• the increased risk of pneumococcal disease in Aboriginal and Torres Strait Islander adults, compared with non-Indigenous adults
• the high proportion of invasive pneumococcal disease caused by additional serotypes only in 23vPPV

Aboriginal and Torres Strait Islander adults who have previously received 23vPPV

• 12 months after their last 23vPPV
• dose, or 5 years after their previous 23vPPV dose, whichever is later. If they have already received at least 2 doses of 23vPPV