RECOMMENDED INTERVALS BY RISK IN IMMUNOCOMPETENT PERSONS WITH INDICATIONS TO RECEIVE PCV13 AND PPSV23 SEQUENCE
PCV13 → PPSV23
19-64 yr ≥ 65 yr
PPSV23 → PCV13
19-64 yr ≥ 65 yr
Cerebrospinal Fluid
Leak
≥ 8 wk ≥ 8 wk
≥ 1 yr ≥ 1 yr
Sickle Cell
Disease/ Other
hemoglobinopathy
≥ 8 wk ≥ 8 wk
≥ 1 yr ≥ 1 yr
TABLE 3
RECOMMENDED VACCINE FOR OTHER PERSONS
WHO ARE IMMUNO-COMPETENT WITH INDICATIONS TO RECEIVE PPSV23 VACCINE
MMWR 2015; 64: 944-947
The recommended intervals by risk for immunocompromised persons to receive the PCV13 and PPSV23 sequence, is found in Table
4. Note that sequence is again listed at > 8 weeks for the PCV13 →
PPSV23 but is listed at ≥ 1 year for PPSV23 → PCV13 sequence.
Recent information suggests that the estimated proportion of adults
aged ≥ 19 years who have received at least one “pneumonia shot” is
22.5 percent for persons 19-64 years and 61.7 percent for person’s
≥ 65 years of age. This is especially important when 70.7 percent
of the adult population ≥ 65 years old had ≥ 10 physician visits in
the last 12 months and that of the persons 19-64 years 38.6 percent
had ≥ 10 physician visits in the last 12 months. (6) This indicates
there were many missed opportunities to administered needed and
recommended vaccines.
Chronic Heart Disease
1) Tomczyk S, Bennett NM, Stoecker C, et al: Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharides vaccine among adults aged ≥ 65 years: recommendations
of the Advisory Committee on Immunizations Practices (ACIP)
Chronic Lung Disease
MMWR Morb Mortal Wkly Rep: 2014; 63: 822-825
Diabetic Mellitus
2) CDC: Use of 13-Valent Pneumococcal Conjugate Vaccine and
23-Valent Pneumococcal Polysaccharides Vaccine for Adults with
Immuno-Compromising Conditions. Recommendations of the
Advisory Committee on Immunization Practices (ACIP)
Alcoholism
Received PPSV23 and at age
65 follow algorithm in Table 1
Chronic Liver Disease
Cigarette
Cochlear Implant
MMWR Morb Mortal Wkly Rep: 2012; 61; 816-819
Congenital Acquired
Asplenia
3) Greenburg RN, Gurtman A, Frenck RW etal. Sequential administrations of 13-valent pneumococcal conjugate vaccine and 23-valent
pneumococcal polysaccharides vaccine in pneumococcal vaccine
naïve adults 60-64 years of age Vaccine 2014: 32: 2364-2374
MMWR 2015; 64: 940-949
TABLE 4
RECOMMENDED INTERVALS BY RISK FOR IMMUNOCOMPROMISED PERSONS TO RECEIVE PCV13
AND PPSV23 SEQUENCES.
Immuno-Compromised
Persons
PCV13 →
PPSV23
19-64 yr ≥ 65 yr
PPSV23 →
PCV13
19-64 yr ≥
65 yr
Congenital or Acquired
J. Infect Dis 2008; 198: 1019-1022.
5) CDC: Intervals between PCV-13 and PPSV23 Vaccines: Recommendations of the Advisory Committee on Immunization Practice
(ACIP)
MMWR 2015: 64: 944-947
Immuno-Deficiency
6) CDC: Surveillance of Vaccinations Coverage Among Adult Populations –United States 2014
Human Immuno-Deficiency
Virus Infection
MMWR Morb Mortal Wkly Rep 2016; 65: 1-36
Chronic Renal Failure
Nephrotic Syndrome
Leukemia
4) Muohen DM, Rueda AM, Nahm, MH et al: Initial and subsequent
response to pneumococcal polysaccharide and protein conjugate
vaccines administered sequentially to adults who have recovered
from pneumococcal pneumonia.
≥ 8 wk ≥ 8 wk
≥ 1 yr ≥ 1 yr
Dr. Gall practices Obstetrics, Gynecology and Women’s Health as part
of the University of Louisville Physicians Group.
Lymphoma
Hodgkin’s disease
Iatrogenic
Immunosuppressive
Solid Organ Transplant
Multiple Myeloma
MAY 2