Pneumococcal
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Streptococcus pneumoniae
picture of pneumococcal

Pneumococcal disease is caused by various strains of Streptococcus pneumoniae bacteria. The main pneumococcal diseases are pneumonia, bacteremia (blood infection), and meningitis (brain infection). Pneumococcal pneumonia is the most common clinical presentation of pneumococcal disease among adults. About 175,000 people are hospitalized in the United States each year because of pneumococcal pneumonia. About 5% to 7% of people with pneumococcal pneumonia will die. In addition, there are more than 50,000 cases per year of pneumococcal bacteremia and up to 6,000 cases of pneumococcal meningitis. The death rates for these two forms of pneumococcal disease can increase to up to 80% in elderly patients.

Pneumococcal bacteria are spread from person to person through respiratory droplets. A person can also be a carrier of pneumococcal bacteria. This means the pneumococcal bacteria can live in the person's respiratory tract without causing symptoms. However, persons who are carriers can also infect themselves and other people.

People who are very young, very old, or who have weak immune systems are at greatest risk for pneumococcal disease and complications from pneumococcal disease. Therefore, these are the groups that are targeted for pneumococcal vaccine administration.

About the Vaccine

There are two pneumococcal vaccines. Both are inactivated vaccines and can help prevent pneumococcal disease.

Pneumococcal Vaccines Licensed for Use in the U.S.

Product: Prevnar 13® (Pneumoococcal Conjugate Vaccine)
Manufacturer: Wyeth
Year licensed: 2010
Product Insert

Product: Pneumovax 23® (Pneumococcal Polysaccharide Vaccine)
Manufacturer: Merck
Year licensed: 1983
Product Insert

Indications Contraindications and precautions
Pneumococcal Conjugate Vaccine
  • All children 6 weeks through 59 months of age.
  • High-risk children 60 through 71 months of age.*
  • High-risk children 6 through 18 years of age dosewith certain condition. *
  • Adults 19 years of age and older with certain conditions. **
Pneumococcal Polysaccharide Vaccine
  • Adults 65 years of age and older.
  • Adults and children who live in areas where the local disease incidence warrants vaccine use.
  • People 2 years of age and older with:
    • chronic illness
    • functional or anatomic asplenia, including sickle cell disease.
    • nephrotic syndrome.
    • cerebral spinal fluid leaks.
    • immunosuppression, including HIV infection.
    • cochlear implants.
    • bone marrow transplant.
  • Adults 19 years of age and older who smoke cigarettes.
  • Adults 19 years of age and older who have asthma.

* Includes children with sickle cell disease, anatomic or functional asplenia, chronic cardiac, pulmonary, or renal disease, diabetes mellitus, CSF leak, immunosuppression, HIV infection, cochlear implants, or bone marrow transplant.

** ACIP recommends Prevnar 13 (PCV13) for adults 19 and older with immunocompromising conditions, functional or anatomic asplenia, cerebrospinal fluid (CSF) leaks, or cochlear impants.

Pneumococcal Conjugate Vaccine
  • People who have had a severe allergic reaction to a previous dose of pneumococcal conjugate vaccine or a vaccine component.*
  • People who are moderately or severely ill should wait until recovery before receiving any vaccine. Minor illnesses, such as a cold, are not a contraindication.
  • Healthy children younger than 6 weeks of age or older than 59 months of age.
  • In adults, antibody responses were diminished when given with inactivated influenza virus vaccine.
Pneumococcal Polysaccharide Vaccine
  • People who have had a severe allergic reaction to a previous dose of pneumococcal polysaccharide vaccine or a vaccine component.
  • People who are moderately or severely ill should wait until recovery before receiving any vaccine. Minor illnesses, such as a cold, are not a contraindication.
  • Children younger than 2 years of age.
  • Administer vaccine before cancer chemotherapy, immunosuppressive therapy, or splenectomy for best effect.
  • The safety of pneumococcal polysaccharide vaccine among pregnant women has not been studied. However, the vaccine can be given to pregnant women with medical indications after provider evaluation.

* Pnuemococcal polysaccharide vaccine contains phenol.

Vaccine Ages Dose/Route Routine Administration Schedule
Prevnar 2 to 7 months of age Dose: 0.5 ml

Route: Intramuscular (IM)
4 doses at 2 months, 4 months, 6 months, and 12 to 15 months of age.
7 to 11 months 3 doses: 2 doses at least 4 weeks apart; third dose after age 12 months and at least 2 months after second dose.
12 to 23 months 2 doses: 2 doses at least 2 months apart.
24 through 59 months Healthy children: 1 dose
High-risk children*: 2 doses at least 8 weeks apart.
60 through 71 months High-risk children*: 2 doses at least 8 weeks apart.
6 through 18 years High-risk children*: 1 dose (per ACIP)
19 years and older High risk adults: 1 dose
Pneumovax 23 2 years of age and older Dose: 0.5 ml

Route: Subcutaneous
Single dose
(NOTE: do not given sooner than 2 months after last dose of Prevnar)

* Includes children with sickle cell disease, anatomic or functional asplenia, chronic cardiac, pulmonary, or renal disease, diabetes mellitus, CSF leak, immunosuppression, HIV infection, cochlear implants, or bone marrow transplant.

Booster dose information
  • A second dose of pneumococcal polysaccharide vaccine is recommended 5 years after the first dose for persons 2 years of age and older who are immunocompromised, have sickle cell disease, or who have functional or anatomic asplenia.
  • A second dose of pneumococcal polysaccharide vaccine is recommended 5 years after the first dose for those 65 years of age or older if the first dose was given prior to age 65.    
Pneumcococcal Conjugate Vaccine Side Effects
  • Soreness, redness, or swelling where the shot was given (about 25%).
  • Fever (about 30%).
  • Fussiness, drowsiness, or loss of appetite (less common).
  • Severe allergic reaction (very rare).
Pneumcococcal Polysaccharide Vaccine Side Effects
  • Soreness, redness, or swelling where the shot was given (about 50%).
  • Fever, muscle aches, or more severe local reaction (less than 1%).
  • Severe allergic reaction (very rare).
Product Name Supplied Storage and Handling
Prevnar 13
Wyeth
0.5 mL single dose prefilled syringes (1 or 10 per package). Store refrigerated between 2° to 8°C (35° to 46°F). Do not freeze. Discard if vaccine has been frozen.

Prevnar is a homogeneous, white suspension. Shake well before use.
Pneumovax 23
Merck
Single dose vial (10 per package) and 5 dose multidose vial (1 per package). Store refrigerated between 2° to 8°C (35° to 46°F). Do not freeze. Discard if vaccine has been frozen.

Pneumovax 23 is a clear, colorless solution.     
Recommendations of the Advisory Committee on Immunization Practices (ACIP)
Recommendations of the Advisory Committee on Immunization Practices (ACIP)
Healthcare professionals are invited to join us as we discuss "Pneumococcal Vaccine Update 2014". COL Margaret Yacovone will provide information on clinical features, ACIP recommendations, policy updates and issues/challenges. (Recorded on 19 Feb 2014)
Topics Covered: Childhood, Adolescent, and Adult Immunization Strategies, and Challenges Advisory Committee on Immunization Practices (ACIP) Updates Influenza Vaccines: Giving the Right Dose at the Right Time Maternal Immunization Pneumococcal Vaccines across the Lifespan Special Populations including Immunocompromised Individuals Travel Vaccines: Don’t Leave Home without Them Vaccine Administration: From Refrigerator to Reimbursement Vaccines in Action
Merck cordially invites you to a medical education program for health care professionals only. Merck is sponsoring this program and the speaker is presenting on behalf of Merck. The program is a non-CME event. Various speakers will: • Describe pneumococcal disease burden • Understand the clinical significance of pneumococcal serotypes • Discuss pneumococcal disease in adult patients
ALARACT PDF 09 Feb 09
STREPTOCOCCAL PNEUMONIAE MENINGITIS AT FORT LEONARD WOOD
02 Jan 14

Sample Q&A: The Vaccine

I am a smoker. Do I need to get pneumococcal vaccine?
Yes, because smoking is a significant risk factor for developing pneumonia. In January 2009, the Advisory Committee on Immunization Practices (ACIP) expanded the pneumococcal vaccine recommendations to include smokers. Click here to read the ACIP guidelines.
National Foundation for Infectious Diseases
Recommendations of the Armed Forces Epidemiological Board (AFEB)
Package Insert - Vaccine
Package Insert - Vaccine
Merck 25 Nov 14
Pneumovax 23
Wyeth 03 Dec 08
Prevnar
VIS
Vaccine Information Statement (Interim)
Author(s): CDC
Publication: MMWR July 9, 2004 / 53(26);589-590
Subject: Vaccine-General
Disease: 
Pneumococcal
Author(s): CDC
Publication: MMWR / 53(05);108-109
Subject: Vaccine-General
Disease: 
Pneumococcal