Pneumoccocal

Question 1

pneumococcal disease

Answer 1

leading cause of vacc-preventable illness and death in US
freq cause of secondary bact pneumonia following influenza
year round threat, antib res

Question 2

pneumococcal disease is caused by

Answer 2

streptococcus pneumonia - a gram-pos bac with a polysacc capsule that colonizes the upper resp tract

Question 3

there are _ based upon polysacc caps

Answer 3

more than 90 serotypes

Question 4

pneumococcal disease can cause

Answer 4

disseminated disease, lower resp tract and upper resp tract infections

Question 5

disseminated diseases

Answer 5

bacteremia
meningitis
arthritis
peritonitis

Question 6

lower resp tract infections

Answer 6

pneumonia

Question 7

upper resp tract infections

Answer 7

sinusitis

otitis media

Question 8

most common pneumococcal vaccines

Answer 8

PPSV23 and PCV13

Question 9

PPSV23

Answer 9

pneumococcal polysaccharide vaccine 23-valent

Question 10

PCV13

Answer 10

pneumococcal conjugate vacc 13-valent

Question 11

PPSV23 is administered

Answer 11

0.5 ml IM (or SC)

Question 12

PCV13 is required in how many doses

Answer 12

1, if given before age 65 no additional needed

Question 13

If no PCV13 or PPSV23 since turning 65

Answer 13

give PCV13 1 yr after PPSV23 given before 65

1 yr from PCV13 and 5 years from last PPSV23 give PPSV23

Question 14

If no PCV13 and PPSV23 has been given since turning 65

Answer 14

give PCV13 1 yr after last PPSV23

Question 15

Select conditions and risks

Answer 15

CHD
CLD
Diabetes
Alcoholism
Cigarettes
Long term or nursing home patients

Question 16

If patient has a select condition or risk and is < 19 yrs old

Answer 16

refer to ped sched

Question 17

if patient has a select condition or risk and is 19-64 yrs old and no PPSV23

Answer 17

give PPSV23

Question 18

if patient has a select condition or risk and is 19-64 yrs old and rec’d PPSV23

Answer 18

reassess at age 65

Question 19

if patient has a select condition or risk and is > or = 65 and no PPSV23 since turning 65

Answer 19

give PCV13 (if none) if its been at least 1 yr since last PPSV23 and 
PPSV23 1 yr after PCV13 but 5 years after last PPSV23

Question 20

if patient is > or = 65 and patient rec’d PPSV23 since turning 65

Answer 20

give PCV13 (if none) 1 yr after last PPSV23

Question 21

other select conditions

Answer 21

immunocom
asplenia
CSF leaks
Cochlear impants

Question 22

if patient has immunocom, asplenia, CSF leaks, or coch implants and is < 19

Answer 22

refer to ped/adolesc sched

Question 23

if patient has immunocom, asplenia, csf leaks, or coch implants and is 19-64 and no PPSV23

Answer 23

give PCV13 (if none)
give PPSV23 8 weeks later
give PPSV23 5 years later (2nd dose not needed for pat with CSF leaks or coch implants)

Question 24

If patient has immunocom, asplenia, csf leaks, or coch implants and is 19-64 and rec’d 1 dose PPSV23

Answer 24

give PCV13 (if none) 1yr after PPSV23
and
give PPSV23 8 weeks later if 5 yrs from last PPSV23

Question 25

If patient has immunocom, asplenia, csf leaks, or coch implants and is 19-64 and rec’d 2 doses of PPSV23

Answer 25

give PCV13 (if none) if 1 yr after last PPSV23

Question 26

** A dose of PCV13 is not needed if

Answer 26

patient rec’d a prev dose of PCV13

Question 27

PCV13 indicated for ages

Answer 27

6 weeks through 5 years

routine sched: 2, 4, 6, 12, 15 mos

Question 28

ACIP recommended PCV13 in

Answer 28

all adults > or = to 65 years and in patients with other select conditions

Question 29

PPSV23 is more efficacious against

Answer 29

bacteremia than pneumonia

not adeq effective in children younger than 2 years

Question 30

Dose and route of PPSV23

Answer 30

0.5ml IM (or SC)

Question 31

Additional considerations for PPSV23

Answer 31

recommend:

• a total of 2 doses 5 yrs apart for patients younger than 65 with immunosupp or aslenia
• 1 dose for patients younger than 65 with coch imlants or csf leaks
• 1 dose for patients 65 and older who rec’d 1 or 2 doses at least 5 yrs ago and when younger than 65