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pneumococcal vaccine polyvalent (Rx)Brand and Other Names:Pneumovax 23

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

vaccine

  • 0.5mL (1 dose)
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Pneumococcal Disease Prevention

Indicated for active immunization for the prevention of pneumococcal disease caused by the 23 serotypes contained in the vaccine

0.5 mL SC/IM

Up-to-date vaccination schedules available at http://www.cdc.gov/vaccines/schedules/hcp/index.html

ACIP Guidelines, Routine Immunization for Immunocompetent Adults

All patients ≥65 years: ACIP recommends routine vaccination with both PPSV23 (23-valent pneumococcal polysaccharide vaccine) and PCV13 (13-valent pneumococcal conjugate vaccine)

MMWR 2015 Sep 4:64(34);944-947

Pneumococcal vaccine-naïve

  • Administer PCV13 first, and then PPSV23 ≥1 yr later

Previous vaccination with PPSV23

  • A dose of PCV13 should be given ≥1 yr after receipt of the most recent PPSV23 dose
  • For those whom an additional dose of PPSV23 is indicated, this subsequent PPSV23 dose should be given 6-12 months after PCV13 and ≥5 yr after the most recent dose of PPSV23

ACIP Guidelines, Immunocompromising Conditions

PCV13 recommended in addition to PPSV23 for adults ≥19 yr with immunocompromising conditions (including chronic renal failure and nephrotic syndrome), functional or anatomic asplenia, cerebrospinal fluid leaks, or cochlear implants who have not previously received PCV13 or PPSV23 (MMWR 2012 Oct 12;61[40]:816-819)

Note: minimum interval between PCV13 and PPSV23 is 8 wk for immunocompromised adults

Dosage Forms & Strengths

vaccine

  • 0.5mL (1 dose)
more...

Pneumococcal Disease Prevention

Indicated for children with high risk conditions including chronic heart or lung disease, diabetes mellitus, cerebrospinal fluid leaks, cochlear implants, anatomic or functional asplenia (including sickle cell disease), or immunocompromised conditions

Do not confuse with routine childhood pneumococcal vaccine PCV13

<2 years: Safety and efficacy not established

≥2 years: 0.5 mL SC/IM for high risk conditions (plus PCV13)

All recommended PCV13 doses should be administered prior to PPSV23 vaccination if possible

Up-to-date vaccination schedules available at http://www.cdc.gov/vaccines/schedules/hcp/index.html

ACIP Guidelines, Aged 2-5 Years

Any of the following conditions:

Chronic heart disease (particularly cyanotic congenital heart disease and cardiac failure)

Chronic lung disease (including asthma if treated with high-dose oral corticosteroid therapy)

Diabetes mellitus Cerebrospinal fluid leak

Cochlear implant

Sickle cell disease and other hemoglobinopathies

Anatomic or functional asplenia

HIV infection

Chronic renal failure

Nephrotic syndrome

Diseases associated with immunosuppressive drugs or radiation therapy, including malignant neoplasms, leukemias, lymphomas, and Hodgkin disease; solid organ transplantation; or congenital immunodeficiency

Dosage for high risk 2-5 years olds

  • 1. Administer 1 dose of PCV13 if 3 doses of PCV (7- or 13-valent) were received previously
  • 2. Administer 2 doses of PCV (7- or 13-valent) at least 8 weeks apart if fewer than 3 doses of PCV13 were received previously
  • 3. Administer 1 supplemental dose of PCV13 if 4 doses of PCV7 or other age-appropriate complete PCV7 series was received previously
  • 4. The minimum interval between doses of PCV (PCV7 or PCV13) is 8 wk
  • 5. For children with no history of PPSV23 vaccination, administer PPSV23 at least 8 wk after the most recent dose of PCV13

ACIP Guidelines, Aged 6-18 Years

Any of the following conditions:

Cerebrospinal fluid leak

Cochlear implant

Sickle cell disease and other hemoglobinopathies

Anatomic or functional asplenia

Congenital or acquired immunodeficiencies

HIV infection

Chronic renal failure

Nephrotic syndrome

Diseases associated with immunosuppressive drugs or radiation therapy, including malignant neoplasms, leukemias, lymphomas, and Hodgkin disease; generalized malignancy; solid organ transplantation; or multiple myeloma

1. If neither PCV13 nor PPSV23 has been received previously, administer 1 dose of PCV13 now and 1 dose of PPSV23 at least 8 wk later

2. If PCV13 has been received previously but PPSV23 has not, administer 1 dose of PPSV23 at least 8 wk after the most recent dose of PCV13

3. If PPSV23 has been received but PCV13 has not, administer 1 dose of PCV13 at least 8 wk after the most recent dose of PPSV23

Heart, lung, diabetes, liver diseases in 6-18 year olds

  • Chronic heart disease (particularly cyanotic congenital heart disease and cardiac failure)
  • Chronic lung disease (including asthma if treated with high-dose oral corticosteroid therapy)
  • Diabetes mellitus
  • Alcoholism
  • Chronic liver disease
  • If the patient has not received PPSV23, administer 1 dose of PPSV23
  • If PCV13 has been received previously, then PPSV23 should be administered at least 8 wk after any prior PCV13 dose

ACIP Guidelines, Revaccination

A single revaccination with PPSV23 should be administered 5 years after the first dose to children with:

Sickle cell disease or other hemoglobinopathies

Anatomic or functional asplenia

Congenital or acquired immunodeficiencies

HIV infection

Chronic renal failure

Nephrotic syndrome

Diseases associated with immunosuppressive drugs or radiation therapy, including malignant neoplasms, leukemias, lymphomas, and Hodgkin disease; generalized malignancy; solid organ transplantation; or multiple myeloma

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Interactions

Interaction Checker

pneumococcal vaccine polyvalent and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Suspected adverse events after administration of any vaccine may be reported to Vaccine Adverse Events Reporting System (VAERS), 1-800-822-7967

            Frequency Not Defined

            Erythema, induration, soreness at inj site

            Low grade fever

            Rash

            N/V

            Lymphadenitis

            ITP relapse

            Hemolytic anemia

            Thrombocytopenia

            Anaphylactoid reaction

            Angioedema

            Serum sickness due to drug

            Guillain-Barre syndrome

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            Warnings

            Contraindications

            Previous vaccination with pneumococcal vaccine, within 10 days of immunosuppressive therapy

            Cautions

            Polysaccharide capsular vaccine against 23 strains of pneumococci (90% of blood isolates & 85% of isolates found in sterile sites)

            CDC now recommends second dose after 5 years for pts with chronic renal failure, asplenia, HIV infection, cancer, or other conditions associated w/immunosuppression

            Splenectomy: administer at least 2 wk before scheduled procedure

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: not known if excreted in breast milk

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            S. pneumoniae capsular antigens stimulate active immune response resulting in production of endogenously produced antibodies

            The 23 serotypes contained in the vaccine include: 1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F, and 33F

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            Administration

            Instructions

            For IM or SC administration

            Inject into the deltoid muscle or lateral mid-thigh

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            Images

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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