Tuesday, January 26, 2016

Pneumococcal Vaccine

Pneumococcal Conjugated Vaccine (PCV) / Prevnar 13

Pneumococcal Polysaccharide Vaccine 23 (PPSV 23) / Pneumovax 23
  • Effective against 13 serotypes that can cause pneumococcal disease
Differences
  • Effective against 23 serotypes that can cause pneumococcal disease
  • Not effective in <2 years old  (poorly immunogenic)

  • <5 years old,
  •  >65 years old
  • 6-64 years old with medical condition


Recommendation
  • >65years old
  • >2year old at high risk
  • 19-64 years old who has the risk factors/underlying medical conditions (eg: smoke, asthmatic)
  • 2months, 4 months, 6 months
  • 13-18months (BOOSTER)
When to give?
  • 19-64 years old: 2nd doses 5 years apart, the 3rd dose given once they turn 65 (provided that the last dose given was 5 years ago)
  • >65 years old: 1 dose only (preferably after PCV13 if has underlying medical conditions)
  • 0.5ml Intramuscular at deltoid muscle
Administration
  • 0.5ml Intramuscular or Subcutaneous injection
  • Available in Malaysia
  • Not available in Hospital Keningau
Availability
  • Available in Malaysia
  • Available in Hospital Keningau
*Risk factors (medical conditions) can be found in the CDC website

RECOMMENDATIONS:
  • Give PCV13 before PPSV23 if possible.
  • For children, if the child has already received PPSV23, wait 8 weeks before giving PCV13.
  • For persons age 65 years and older who have not previously received pneumococcal vaccine or whose pneumococcal vaccine history is unknown, give PCV13 followed by PPSV23 12 months later. 
  • For adults 19 through 64 years at high risk of pneumococcal disease give PCV13 followed by PPSV23 at least 8 weeks later.
  • For adults, if the person has already received PPSV23, wait 12 months before giving PCV13.
  • Pneumococcal vaccine is not listed in the new immunization schedule Malaysia 2016
REFERENCES
2. Advisory Committee on Immunization Practices (ACIP) http://www.cdc.gov/vaccines/vpd-vac/pneumo/vacc-in-short.htm
3. www.uptodate.com
4. http://www.immunize.org/askexperts/experts_pneumococcal_vaccines.asp

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