How Much Is Pneumococcal Vaccine

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 6-17 year olds

• Any of the following conditions:
• 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

More Than 215 Million Children Reached

In 2019, for the first time, pneumococcal vaccine coverage in Gavi-supported countries was higher than the worldwide average: 49% in 2019, up from 37% in 2015 and above the global average of 48%. This reflects a decade of progress and hard work by countries and Vaccine Alliance partners to support the introduction of pneumococcal vaccine into routine immunisation programmes and to scale up coverage.

Gavi contributed to the development of UNICEF and WHOs integrated Global Action Plan for Pneumonia and Diarrhoea , which in 2013 set a target to reduce mortality from pneumonia in children aged under five to fewer than 3 per 1,000 live births.

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How Does The Pneumonia Vaccine Work

Getting the pneumonia vaccine is an effective way to protect yourself against pneumonia. Itâs given as a single injection, usually into your upper arm.

Both types of pneumonia vaccine help your body to produce antibodies to protect against the pneumococcal bacteria that causes pneumonia. This means youâre less likely to become seriously ill if you do come into contact with the bacteria.

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Who Should Get Immunised Against Pneumococcal Disease

Anyone who wants to protect themselves against pneumococcal disease can talk to their doctor about getting immunised.

Pneumococcal immunisation is recommended for:

• infants and children aged under 5 years
• non-Indigenous adults aged 70 years and over without medical risk conditions for pneumococcal disease
• Aboriginal and Torres Strait Islander children aged under 5 years living in Northern Territory, Queensland, South Australia and Western Australia
• Aboriginal and Torres Strait Islander adults aged 50 years and over without medical risk conditions for pneumococcal disease
• infants under 12 months diagnosed with certain medical risk conditions for pneumococcal disease
• people over 12 months with certain medical risk conditions for pneumococcal disease

There are two types of pneumococcal vaccine provided free under the National Immunisation Program for different age groups and circumstances:

Refer to the NIP schedule for vaccine dosage information. Your doctor or vaccination provider will advise if you or your child have a specified medical risk condition.

Refer to the pneumococcal recommendations in the Australian Immunisation Handbook for more information.

How Is The Pneumococcal Vaccine Made

Like the Hib vaccine, the pneumococcal vaccine is made from the sugar coating of the bacteria. Antibodies directed against the pneumococcal polysaccharide protect the child without having to take the risk that their first encounter with natural pneumococcus will result in permanent disabilities or death.

Unfortunately, children less than 2 years old don’t develop very good immune responses to this polysaccharide alone. So the pneumococcal vaccine was made in a manner similar to the Hib vaccine . The pneumococcal polysaccharide is linked to a harmless protein. This version of the vaccine is referred to as the pneumococcal conjugate vaccine. Once linked, young children are able to make an immune response to the polysaccharide. The big difference between the pneumococcal vaccine and the Hib vaccine is the number of different types of polysaccharides that need to be included in the vaccine. Whereas, there is really only one strain of Hib that causes disease in children, there are about 90 different strains of pneumococcus. Fortunately, most of the serious disease in young children is caused by the 13 strains of pneumococcus contained in the vaccine.

The pneumococcal vaccine was found to be highly effective in preventing severe pneumococcal infection in a large trial of children injected with the vaccine. About 40,000 children were included in the initial trial of the vaccine. Since its licensure, the pneumococcal vaccine has been given to millions of children safely.

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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

Which Pneumonia Vaccine Is Best

There is no best pneumonia vaccine. The two available pneumonia vaccines are different, and which one is best for you depends on how old you are and whether or not you have certain medical conditions.

The main difference between Prevnar 13 and Pneumovax 23 is the number of pneumococcus strains the vaccine protects against.

• PCV13 contains polysaccharides from 13 types of pneumococcal bacteria and is mainly given to young children.

• PPSV23 contains polysaccharides from 23 types of pneumococcal bacteria and is mainly given to older adults.

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Whats The Difference Between Pcv13 And Ppsv23

• Both vaccines help prevent pneumococcal complications like bacteremia and meningitis.
• Youll need more than one pneumonia shot during your lifetime. A 2016 study found that, if youre over 64, receiving both the PCV13 shot and the PPSV23 shot provide the best protection against all the strains of bacteria that cause pneumonia.
• Dont get the shots too close together. Youll need to wait about a year in between each shot.
• Check with your doctor to make sure youre not allergic to any of the ingredients used to make these vaccines before getting either shot.

• a vaccine made with diphtheria toxoid
• another version of the shot called PCV7
• any previous injections of a pneumonia shot

• are allergic to any ingredients in the shot
• have had severe allergies to a PPSV23 shot in the past
• are very sick

The Ratcheting Price Of The Pneumococcal Vaccine: What Gives

Every November, like clockwork, she gets the same letter, said Dr. Lindsay Irvin, a pediatrician in San Antonio.

Its from the drug company Pfizer Inc., and it informs her that the price tag for the pneumococcal vaccine Prevnar 13 is going up. Again.

And it makes her angry.

Theyre the only ones who make it, she said. Its like buying gas in a hurricane or Coke in an airport. They charge what they want to.

The Advisory Committee on Immunization Practices , a consultatory panel to the federal Centers for Disease Control and Prevention, recommends Prevnar 13 for all children younger than 2 given at 2, 4, 6 and 15 months as well as for adults 65 and older.

It protects against pneumonia as well as ear and other infections. Many states require proof that children have received the vaccine in order to attend school.

The vaccines formulation has remained mostly unchanged since its 2010 federal approval, but its price continues creeping up, increasing by about 5 or 6 percent most years. In just eight years, its cost has climbed by more than 50 percent.

It is among the most expensive vaccines Irvin provides her young patients.

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An Ounce Of Prevention Is Worth A Pound Of Cure

In the 1940s all of the strains of pneumococcus could be treated with the antibiotic, penicillin. However, over time many pneumococcal strains have become resistant not only to penicillin, but also to other antibiotics developed to combat bacterial infections. Resistance means that bacteria have changed, or evolved, so that they are no longer killed by one or more antibiotics. As a result, treatment with those antibiotics is not effective against those resistant strains.

Strains of pneumococcus have now been identified that are highly resistant to most antibiotics. Our reliance on and overuse of antibiotics have led to this resistance, backing us into a corner when treating infections caused by these and other types of bacteria. Unfortunately, we have taken our first steps into a post-antibiotic era. This makes the use of vaccines all the more important.

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.

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Common And Local Adverse Events

Pneumococcal conjugate vaccine

Studies of Pneu-C-13 vaccine indicated that irritability decreased appetite increased or decreased sleep and pain, swelling and redness at the injection site after the toddler dose and in older children, are common side effects. Low grade fever occurred in 20% to 30% or more of vaccine recipients. In adults over 50 years of age, the most commonly reported side effects included pain at the injection site, fatigue, headache and new onset of myalgia, with fever above 38°C occurring in approximately 3% of vaccine recipients.

Pneumococcal polysaccharide vaccine

Reactions to Pneu-P-23 vaccine are usually mild. Soreness, redness and swelling at the injection site occur in 30% to 60% of vaccine recipients and more commonly follow SC administration than IM administration. Occasionally, low grade fever may occur. Re-immunization of healthy adults less than 2 years after the initial dose is associated with increased injection site and systemic reactions. Studies have suggested that re-vaccination after an interval of at least 4 years is not associated with an increased incidence of adverse side effects. However, severe injection site reactions, including reports of injection site cellulitis and peripheral edema in the injected extremity, have been documented rarely with Pneu-P-23 vaccine in post-marketing surveillance, even with the first dose. Multiple re-vaccinations are not recommended refer to Booster doses and re-immunization.

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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Acip Guidelines Aged 2

Any of the following conditions:

Chronic heart disease

Chronic lung disease

Diabetes mellitus

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

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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Cost Of Pneumococcal Vaccine Keeps Rising

Every November, like clockwork, she gets the same letter, said Lindsay Irvin, a pediatrician in San Antonio.

Its from the drug company Pfizer Inc., and it informs her that the price tag for the pneumococcal vaccine Prevnar 13 is going up. Again.

And it makes her angry.

Theyre the only ones who make it, she said. Its like buying gas in a hurricane or Coke in an airport. They charge what they want to.

The Advisory Committee on Immunization Practices , a consultatory panel to the federal Centers for Disease Control and Prevention, recommends Prevnar 13 for all children younger than 2 given at 2, 4, 6 and 15 months as well as for adults 65 and older.

It protects against pneumonia as well as ear and other infections. Many states require proof that children have received the vaccine in order to attend school.

The vaccines formulation has remained mostly unchanged since its 2010 federal approval, but its price continues creeping up, increasing by about 5% or 6% most years. In just eight years, its cost has climbed by more than 50%.

It is among the most expensive vaccines Irvin provides her young patients.

Doctors and clinics purchase the vaccine and then, once they inject patients, they typically recoup the cost through patients insurance coverage. In most cases there are no out-of-pocket costs.

But the steady rise in prices for branded drugs contributes indirectly to rises in premiums, deductibles and government health spending, analysts say.

Which Adults Should Get The Pneumococcal Vaccine

The following groups of adults should get both types of the pneumococcal vaccine :

• Adults 65 years and older because they are at high risk of pneumococcal infections
• Adults without a functioning spleen
• Adults who are immune compromised by disease, chemotherapy or steroids
• Individuals who are HIV positive

The following groups of adults should get the polysaccharide pneumococcal vaccine regardless of age:

• Adults who smoke or suffer from alcoholism
• Adults with heart or lung disease, liver disease, asthma, diabetes or cancer

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When To See A Doctor

A person who is over 65 years of age should talk to their doctor about which pneumonia vaccine may be best for them. The doctor can help determine whether they should get the vaccination, which vaccination to get, and when to get it.

Parents and caregivers of young children should talk to a pediatrician about the schedule for the pneumonia vaccination. The pediatrician can also address any questions or concerns about the safety and effectiveness of the vaccination.

A person does not need to see a doctor for mild reactions to the vaccine, such as tenderness at the injection site, fever, or fatigue.

However, if a person experiences any life threatening side effects, they should seek emergency help immediately.

Signs and symptoms of allergic reactions in children may include:

• respiratory distress, such as wheezing