Pneumococcal Vaccine

(Pneumococcal Conjugate Vaccine; PCV; Pneumococcal Polysaccharide Vaccine; PPSV)

What Is Pneumococcal Disease?

What Is Pneumococcal Disease?

Pneumococcal disease is an infection caused by bacteria. It can lead to:

It is spread by person-to-person contact.

What Is the Pneumococcal Vaccine?

What Is the Pneumococcal Vaccine?

There are two types of pneumococcal vaccines:

  • Pneumococcal conjugate vaccine (PCV)—Recommended for infants and toddlers. The PCV13 vaccine protects against 13 types of pneumococcal bacteria.
  • Pneumococcal polysaccharide vaccine (PPSV)—Recommended for certain children and adults. The PCV23 vaccine protects against 23 types of pneumococcal bacteria.

The vaccines are made from inactivated bacteria. They are given by injection under the skin or into the muscle. The goal of getting a vaccine is that later, when you are exposed to the bacteria, you will not get sick from it.

Who Should Get Vaccinated and When?

Who Should Get Vaccinated and When?

PCV

The PCV is routinely given in four doses at 2, 4, 6, and 12-15 months. It can also be given to children with high-risk conditions.

If your child has not been vaccinated or missed a dose, talk to the doctor. Depending on your child’s age, additional doses may be needed. Also, an additional dose may be needed if your child:

  • Is less than 5 years old and was given PCV7, which is an earlier version of the vaccine
  • Has a condition that increases the risk of severe disease

PPSV

The PPSV is given to adults aged 65 and older.

PPSV is also given to anyone aged 2 to 64 who has certain conditions, such as:

  • Heart or lung disease
  • Sickle cell disease
  • Diabetes
  • Alcoholism
  • Cirrhosis
  • Cerebrospinal fluid leaks
  • Cochlear implants
  • Hodgkin’s disease
  • Lymphoma or leukemia
  • Kidney failure
  • Multiple myeloma
  • Nephrotic syndrome
  • HIV or AIDS or other disease the creates a weak immune system
  • Damaged spleen or no spleen
  • An organ transplant

PPSV is also given to anyone aged 2 to 64 who is taking a drug or treatment that lowers the body’s ability to resist infection, such as:

  • Long-term steroids
  • Certain cancer drugs
  • Radiation therapy

The vaccine should be given at least 2 weeks before cancer treatment begins.

PPSV should also be given to any adult aged 19 to 64 years old who:

  • Is a smoker
  • Has asthma

In some cases, a second dose of PPSV may be needed. For example, a second dose is recommended for people 65 and older who got their first dose before they turned 65 and it has been more than 5 years since that dose. A second dose is also recommended for people 2 through 64 who have:

  • A damaged spleen or no spleen
  • Sickle cell disease
  • HIV infection or AIDS
  • Cancer, leukemia, lymphoma, or multiple myeloma
  • Nephrotic syndrome
  • An organ or bone marrow transplant
  • Been taking medication that lowers immunity, such as chemotherapy or long-term steroids

When a second dose is given, it should be 5 years after the first dose.

What Are the Risks Associated With the Pneumococcal Vaccine?

What Are the Risks Associated With the Pneumococcal Vaccine?

PCV

Generally, all vaccines have a small risk of serious problems. Side effects of PCV include:

  • Redness, tenderness, or swelling at the injection site
  • Fever
  • Drowsiness
  • Loss of appetite
  • Irritability

Acetaminophen is sometimes given to reduce pain and fever that may occur after getting a vaccine. Giving the medication at the time of the shot may weaken the vaccine’s effectiveness. Discuss the risks and benefits of taking acetaminophen with the doctor.

PPSV

Half of the people who get the vaccine have mild side effects. However, developing the disease is much more likely to cause serious problems than getting the vaccine. Side effects may include:

  • Redness or pain at the injection site
  • Fever
  • Muscle aches
  • Severe allergic reactions—rare

Who Should Not Get Vaccinated?

Who Should Not Get Vaccinated?

PCV

Children who should not receive the vaccine are those who:

  • Have had a life-threatening allergic reaction to a previous dose of PCV
  • Have had a severe allergy to one of the vaccine’s parts
  • Are very ill

PPSV

You should not receive the PPSV if you:

  • Had a life-threatening allergic reaction to a previous dose of PPSV
  • Had a severe allergy to one of the vaccine’s components
  • Are very ill

What Other Ways Can Pneumococcal Disease Be Prevented Besides Vaccination?

What Other Ways Can Pneumococcal Disease Be Prevented Besides Vaccination?

You can prevent pneumococcal disease if you:

  • Avoid close contact with people who have infections.
  • Wash your hands regularly to reduce your risk of infection.

What Happens in the Event of an Outbreak?

What Happens in the Event of an Outbreak?

In the event of an outbreak, all people who are eligible for a vaccine should receive it.

References:

Pneumococcal conjugate vaccine. Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/vaccines/hcp/vis/vis-statements/pcv13.pdf
Updated February 27, 2013. Accessed August 29, 2013.

Pneumococcal disease. Immunization Action Coalition website. Available at:
http://www.vaccineinformation.org/pneumchild/qandavax.asp
Updated May 29, 2013. Accessed August 29, 2013.

Pneumococcal polysaccharide vaccine. Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/vaccines/hcp/vis/vis-statements/ppv.pdf
Updated October 6, 2009. Accessed August 29, 2013.

Pneumococcal: understanding the disease. National Network for Immunization Information website. Available at:
http://www.immunizationinfo.org/vaccines/pneumococcal-disease
Updated March 31, 2010. Accessed August 29, 2013.

Recommended immunizations for adults by age. Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/vaccines/schedules/downloads/adult/adult-schedule-easy-read.pdf
Accessed August 29, 2013.

Recommended immunization schedule for persons aged 0 through 18 years—2013. Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/vaccines/schedules/downloads/child/0-18yrs-schedule.pdf
Accessed August 27, 2013.

10/30/2009 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Prymula R, Siegrist C, et al. Effect of prophylactic paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: two open-label, randomised controlled trials. Lancet. 2009;374(9698):1339.

9/17/2010 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Centers for Disease Control and Prevention. Updated recommendations for prevention of invasive pneumococcal disease among adults using the 23-valent pneumococcal polysaccharide vaccine (PPSV23). MMWR Morb Mortal Wkly Rep. 2010;59(34):1102-1106.

1/7/2011 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Nuorti J, Whitney C, et al. Prevention of pneumococcal disease among infants and children—use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine. MMWR Morb Mortal Wkly Rep. 2010;59(34):1102. Centers for Disease Control and Prevention (CDC); Advisory Committee on Immunization Practices.

Updated recommendations for prevention of invasive pneumococcal disease among adults using the 23-valent pneumococcal polysaccharide vaccine (PPSV23). MMWR Morb Mortal Wkly Rep. 2010;59(34):1102-1106. Centers for Disease Control and Prevention (CDC); Advisory Committee on Immunization Practices. Licensure of a 13-Valent pneumococcal conjugate vaccine (PCV13) and recommendations for use among children. MMWR Recomm Rep. 2010;59(RR-11):1.

2/10/2014 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Akinsanya-Beysolow I, Immunization Services Division, et al. Advisory Committee on Immunization Practices recommended immunization schedules for persons aged 0 through 18 years—United States, 2014. MMWR Morb Mortal Wkly Rep. 2014;63(5):108-109.

Last reviewed December 2014 by David L. Horn, MD, FACP
Last Updated: 12/20/2014

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