pneumococcal vaccine

Question 1

with pneumonia, there is a Major source of morbidity and mortality in what patients?

Answer 1

<1 year of age, elderly, and immunocompromised patients

Question 2

invasive diseases such as __, __, and ___ can increase risk of mortality with pneumonia.

Answer 2

pneumonia, meningitis, and bacteremia

Question 3

Pneumonia Vaccination is no guarantee to not get disease, but studies have shown a decrease in what?

Answer 3

severity and long-term problems

Question 4

who is the pneumococcal vaccine recommended for?

Answer 4

o All children–> part of pediatric schedule of vaccines
o Adults (19-64 yrs) who have a condition that places them at risk for pneumonia or invasive disease will get it again
o All adults ≥65 years of age will get it again

Question 5

what are the two types of pneumococcal vaccines?

Answer 5

Pneumococcal polysaccharide vaccine (PPSV23; Pneumovax or Pnu-Immune)

Pneumococcal conjugate vaccine (PCV13; Prevnar 13)

Question 6

which pneumococcal vaccine should Not to be used in children <24 months due to poor immunogenic response

Answer 6

Pneumococcal polysaccharide vaccine (PPSV23; Pneumovax or Pnu-Immune)

Question 7

which pneumococcal vaccine do we use in children?

Answer 7

Pneumococcal conjugate vaccine (PCV13; Prevnar 13)

Question 8

PCV13 is recommended for what underlying conditions in immunocompetent individuals?

Answer 8

Cerebrospinal fluid leak
Cochlear implant
Age ≥65

Question 9

what two risk groups should receive PCV13 no matter what the underlying conditions are?

Answer 9

asplenic and immunocompromised

Question 10

Inidications for getting the PPSV23 vaccine

Answer 10

• Cigarette smoking
• Chronic heart disease (including congestive heart failure and cardiomyopathy, but excluding hypertension)
• Chronic lung disease, including asthma and chronic obstructive pulmonary disease
• Diabetes mellitus
• Alcoholism
• Chronic liver disease

Question 11

Indications for getting both the PCV13 and PPSV23

Answer 11

• Age ≥65 years
• Cerebrospinal fluid leak
• Cochlear implant
• Functional or anatomic asplenia, including sickle cell disease, other hemoglobinopathies, congenital asplenia, and acquired asplenia
• Immunocompromise:
  o Congenital or acquired immunodeficiency, including B or T lymphocyte deficiency, complement deficiencies (particularly C1, C2, C3, and C4 deficiencies), and phagocytic disorders (excluding chronic granulomatous disease)
  o HIV infection
  o Chronic renal failure
  o Nephrotic syndrome
  o Leukemia
  o Lymphoma
  o Hodgkin disease
  o Multiple myeloma
  o Generalized malignancy
  o Iatrogenic immunosuppression, including glucocorticoids or radiation
  o Solid organ transplant

Question 12

who gets Revaccination with PPSV23 per CDC guidelines?

Answer 12

• Immunocompromised patients and individuals with functional or anatomic asplenia who are <65 years of age (19-64)
• All adults aged ≥65 years should receive a dose of PPSV23 even if they were vaccinated when they were <65 years of age

Question 13

when should you be revaccinated for the PPSV23? (time length)

Answer 13

One single revaccination ≥5 years after the first dose

Question 14

should adults get revaccinated with PCV13?

Answer 14

no

Question 15

PCV13 should be administered at least__after PPSV23.

Answer 15

1 year

Question 16

PPSV23 should be administered at least 1 year after PCV13, except among adults with immunocompromising conditions, anatomical or functional asplenia, cerebrospinal fluid leak, or cochlear implant, for whom the interval should be at least 8 weeks; the interval between PPSV23 doses should be at least_____.

Answer 16

5 years

Question 17

When both PCV13 and PPSV23 are indicated, what should be administered first?

Answer 17

When both PCV13 and PPSV23 are indicated, PCV13 should be administered first; PCV13 and PPSV23 should not be administered during the same visit.