pneumococcal vaccine polyvalent (Rx)

Brand and Other Names:Pneumovax 23
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

vaccine

  • 0.5mL (1 dose)

Pneumococcal pneumoniae Immunization

Pneumococcal vaccine polyvalent (PPSV23) is 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 1 dose of PPSV23
  • If PPSV23 was administered before age 65 yr, administer 1 dose PPSV23 at least 5 yr after previous dose

ACIP guidelines, chronic medical conditions

  • Aged 19-64 years: 1 dose PPSV23
  • Chronic medical conditions include chronic heart (excluding hypertension), lung, or liver disease; diabetes, alcoholism, or cigarette smoking

ACIP guidelines, cerebrospinal fluid leak or cochlear implant

  • 1 dose PCV13 followed by 1 dose pneumococcal vaccine polyvalent (PPSV23) at least 8 weeks later
  • At age ≥65 yr, administer another dose PPSV23 at least 5 yr after previous PPSV23
  • Note: Only 1 dose PPSV23 recommended at age ≥65 yr

ACIP guidelines, immunocompromising conditions

  • 1 dose PCV13 followed by 1 dose PPSV23 at least 8 weeks later, THEN another dose PPSV23 at least 5 yr after previous PPSV23
  • At age ≥65 yr, administer 1 dose PPSV23 at least 5 yr after most recent PPSV23
  • Note: Only 1 dose PPSV23 recommended at age ≥65 yr
  • Immunocompromising conditions
    • Congenital or acquired immunodeficiency, including B- and T-lymphocyte deficiency, complement deficiencies, phagocytic disorders, HIV infection
    • Chronic renal failure
    • Nephrotic syndrome
    • Leukemia
    • Lymphoma
    • Hodgkin disease
    • Generalized malignancy
    • Iatrogenic immunosuppression (eg, drug, radiation therapy)
    • Solid organ transplant
    • Multiple myeloma
    • Anatomical or functional asplenia, including sickle cell disease and other hemoglobinopathies

Dosing Considerations

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

Dosage Forms & Strengths

vaccine

  • 0.5mL (1 dose)

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

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            Contraindicated (2)

            • belimumab

              belimumab decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Contraindicated. Do not administer live vaccines 30 days before or concurrently with belimumab.

            • zoster vaccine live

              pneumococcal vaccine polyvalent decreases effects of zoster vaccine live by Other (see comment). Contraindicated. Comment: Reduced immune response to zoster vaccine live as measured by gpELISA when coadministered with pneumococcal vaccine polyvalent compared with those who received the vaccines 4 weeks apart.

            Serious - Use Alternative (36)

            • adalimumab

              adalimumab decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • alefacept

              alefacept decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • anakinra

              anakinra decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • antithymocyte globulin equine

              antithymocyte globulin equine decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • antithymocyte globulin rabbit

              antithymocyte globulin rabbit decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • azathioprine

              azathioprine decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • basiliximab

              basiliximab decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • brodalumab

              brodalumab, pneumococcal vaccine polyvalent. immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating brodalumab, complete all age appropriate immunizations. No data are available on the ability of live or inactive vaccines to elicit an immune response in patients being treated with brodalumab.

            • budesonide

              budesonide decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.

            • canakinumab

              canakinumab decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • cortisone

              cortisone decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.

            • deflazacort

              deflazacort decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.

            • dexamethasone

              dexamethasone decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.

            • etanercept

              etanercept decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • everolimus

              everolimus decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • fludrocortisone

              fludrocortisone decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.

            • glatiramer

              glatiramer decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • golimumab

              golimumab decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • hydrocortisone

              hydrocortisone decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.

            • hydroxychloroquine sulfate

              hydroxychloroquine sulfate decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • infliximab

              infliximab decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • ixekizumab

              ixekizumab decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating ixekizumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with ixekizumab may not elicit an immune response sufficient to prevent disease.

            • leflunomide

              leflunomide decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • methylprednisolone

              methylprednisolone decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.

            • muromonab CD3

              muromonab CD3 decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • mycophenolate

              mycophenolate decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • ofatumumab SC

              ofatumumab SC decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Administer all immunizations according to immunization guidelines at least 2 weeks before initiating ofatumumab SC for inactivated vaccines, and whenever possible.

            • prednisolone

              prednisolone decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.

            • prednisone

              prednisone decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.

            • rilonacept

              rilonacept decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • secukinumab

              secukinumab decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.

            • siponimod

              siponimod decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Pause vaccinations beginning 1 week before initiating siponimod and for 4 weeks after stopping treatment. Coadministration with live attenuated vaccines may increase infection risk.

            • sirolimus

              sirolimus decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • tacrolimus

              tacrolimus decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • temsirolimus

              temsirolimus decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • triamcinolone acetonide injectable suspension

              triamcinolone acetonide injectable suspension decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.

            Monitor Closely (16)

            • certolizumab pegol

              certolizumab pegol decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Use Caution/Monitor.

            • cyclosporine

              cyclosporine decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. If possible, complete all age-appropriate vaccinations at least 2 weeks before initiating immunosuppressant therapy. Patients vaccinated <14 days before starting immunosuppressive therapy or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued if immune competence has been restored. Longer waiting periods may be required for drugs that maintain their immunosuppressive effects for more than 3 months after discontinuation (eg, ocrelizumab). .

            • dengue vaccine

              dengue vaccine, pneumococcal vaccine polyvalent. unspecified interaction mechanism. Use Caution/Monitor. Data are not available to establish safety and immunogenicity of coadministration of dengue vaccine with recommended adolescent vaccines.

            • ibrutinib

              ibrutinib decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .

            • ifosfamide

              ifosfamide decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .

            • lomustine

              lomustine decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .

            • mechlorethamine

              mechlorethamine decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .

            • melphalan

              melphalan decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .

            • mercaptopurine

              mercaptopurine decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressants also increase risk of infection with concomitant live vaccines.

            • methotrexate

              methotrexate decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Use Caution/Monitor. Concomitant administration of methotrexate can decrease the immunological response of vaccines.

            • onasemnogene abeparvovec

              onasemnogene abeparvovec decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Adjust vaccinations to accommodate concomitant corticosteroid administration prior to and following onasemnogene abeparvovec infusion. When initiating systemic corticosteriod therapy, wait 2 weeks after an inactivated vaccine.

            • oxaliplatin

              oxaliplatin decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .

            • procarbazine

              procarbazine decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .

            • ustekinumab

              ustekinumab decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Use Caution/Monitor. Inactivated vaccinations administered during ustekinumab treatment may not elicit an immune response sufficient to prevent disease.

            • voclosporin

              voclosporin decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.

            • zoster vaccine recombinant

              pneumococcal vaccine polyvalent decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant.

            Minor (2)

            • chloroquine

              chloroquine decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Minor/Significance Unknown.

            • ozanimod

              ozanimod decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Minor/Significance Unknown. No clinical data are available on the efficacy and safety of vaccinations in patients taking ozanimod. Vaccinations may be less effective if coadministered with ozanimod.

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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

            Defer vaccination in persons with moderate or severe acute illness

            Exercise caution and appropriate care in individuals with severely compromised cardiovascular and/or pulmonary function in whom a systemic reaction would pose significant risk

            This vaccine does not replace the need for penicillin (or other antibiotic) prophylaxis against pneumococcal infection. In patients who require penicillin (or other antibiotic) prophylaxis against3

            Vaccine does not replace need for penicillin (or other antibiotic) prophylaxis against pneumococcal infection; in patients who require penicillin (or other antibiotic) prophylaxis against neumococcal infection, such prophylaxis should not be discontinued after vaccination

            Persons who are immunocompromised, including persons receiving immunosuppressive therapy, may have a diminished immune response to vaccine

            Vaccine may not be effective in preventing pneumococcal meningitis in patients who have chronic cerebrospinal fluid (CSF) leakage resulting from congenital lesions, skull fractures, or neurosurgical procedures

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            Pregnancy & Lactation

            Pregnancy

            Human data from clinical trials in pregnancy have not been established the presence or absence of a vaccine-associated risk

            Developmental toxicity studies have not been conducted in animals

            Lactation

            Unknown if excreted in human 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

            BRAND FORM. UNIT PRICE PILL IMAGE
            Pneumovax-23 injection
            -
            25 mcg/0.5 mL solution
            Pneumovax-23 injection
            -
            25 mcg/0.5 mL solution
            Pneumovax-23 injection
            -
            25 mcg/0.5 mL vial

            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

            Patient Education
            pneumococcal 23 polyvalent vaccine injection

            PNEUMOCOCCAL POLYSACCHARIDE VACCINE - INJECTION

            (NEU-mo-KOK-al)

            COMMON BRAND NAME(S): Pneumovax 23, Pnu-Imune 23

            USES: This vaccine helps protect against serious infection (e.g., meningitis, bacteria in the blood) due to certain bacteria (Streptococcus pneumoniae). This vaccine is important for preventing infection in individuals at risk (e.g., those with heart disease, lung disease, liver disease, diabetes, alcoholism, spleen problems, sickle cell anemia, or HIV, or those living in a nursing home).

            HOW TO USE: Read all vaccine information available from your health care professional before receiving the vaccine. If you have any questions, ask your health care professional.This vaccine is injected into a muscle or under the skin by a health care professional. When this vaccine is injected into a muscle, it is given in the upper arm or thigh.You may need to have another dose of vaccine if you are still at high risk for infection. This is especially true if you are younger than 65 years old when you receive the first dose of this vaccine. A second dose should not be given until 5 years after your first dose. Ask your health care professional for more details.If you are receiving this vaccination before spleen surgery or before receiving cancer chemotherapy or other drugs that decrease your immune system function, it should be given at least 2 weeks before these procedures to be effective. Talk to your health care professional for more information.

            SIDE EFFECTS: Injection site reactions (e.g., pain, redness, swelling, hard lump), muscle/joint aches, or fever may occur. Ask your health care professional whether you should take a fever/pain reducer (e.g., acetaminophen) to help treat these symptoms. Nausea and vomiting may also occur. If any of these effects persist or worsen, tell your health care professional promptly.Rarely, some people have symptoms such as fainting, dizziness, vision changes, or ringing in the ears just after getting a vaccine injection. Tell your health care professional right away if you have any of these symptoms. Sitting or lying down may help, since these symptoms usually don't last long.Remember that this medication has been prescribed because your health care professional has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your health care professional right away if you have any serious side effects, including: unusual weakness, tingling/numbness of the hands/feet, swollen glands.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice any other effects not listed, contact your health care professional.Contact the health care professional for medical advice about side effects. The following numbers do not provide medical advice, but in the US you may report side effects to the Vaccine Adverse Event Reporting System (VAERS) at 1-800-822-7967. In Canada, you may call the Vaccine Safety Section at Public Health Agency of Canada at 1-866-844-0018.

            PRECAUTIONS: Before you receive this vaccine, tell the health care professional if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as the preservative phenol, latex or dry natural rubber in the vial stopper), which can cause allergic reactions or other problems. Talk to your health care professional for more details.Before using this vaccine, tell your health care professional your medical history, especially of: your vaccination/immunization history, recent illness/fever, immune system disorders (such as due to HIV infection, certain cancers such as leukemia/lymphoma, cancer or radiation treatment).This vaccine is not recommended for use in children younger than 2 years.During pregnancy, this vaccine should be used only when clearly needed. Discuss the risks and benefits with your health care professional.It is unknown if this vaccine passes into breast milk. Consult your health care professional before breast-feeding.

            DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your health care professional. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this vaccine include: drugs that weaken the immune system (including cyclosporine, tacrolimus, cancer chemotherapy, corticosteroids such as prednisone).

            OVERDOSE: Not applicable.

            NOTES: It is important to understand the risks and benefits of vaccinations. Discuss this with your health care professional.Talk to your health care professional about the need for other vaccines to prevent possibly severe illness (e.g., flu shots).Make sure all of your health care professionals know you have received this vaccine. Make sure a note is placed in your medical record of having received this vaccine.

            MISSED DOSE: Not applicable.

            STORAGE: Store in the refrigerator. Do not freeze. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

            Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

            IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
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            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            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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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.