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

1. http://www.immunize.org/catg.d/p2015.pdf

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