What are the ACIP and AAP recommendations for immunization of children against pneumococcal infection?

Updated: Aug 27, 2018
  • Author: Claudia Antonieta Nieves Prado, MD; Chief Editor: John L Brusch, MD, FACP  more...
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Answer

Recommendations for universal vaccination in all children aged 59 months and younger in the United States are now in place. In addition, PCV13 use is recommended in children aged 60-71 months with underlying medical conditions placing them at increased risk for pneumococcal disease and its complications. Health care providers considering vaccination should refer to the ACIP guidelines and the American Academy of Pediatrics policy statement on recommendations for immunization of children against pneumococcal disease, outlined as follows [73] :

  • A 4-shot series should be given at ages 2, 4, 6, and 12-15 months.
  • Immunization with PCV13 has replaced PCV7. Children who have received one of more doses of PCV7 should have those doses counted, but complete the series with PCV13.
  • Catch-up immunization should be pursued in all children aged 59 months or younger who are incompletely immunized for age using current recommendations by the American Academy of Pediatrics and ACIP. PCV13 replaces the use and previous recommendations for PCV7. [7, 74]
  • Healthy children aged 24-59 months who have an incomplete schedule of immunization with one of the conjugate vaccines should receive a single dose of PCV13.
  • Children aged 24-71 months who are at high risk for pneumococcal disease with an incomplete schedule of fewer than 3 doses should receive 2 doses of conjugate vaccine 2 months apart, followed at least 2 months later by 1 dose of polysaccharide vaccine. Children with an incomplete schedule of 3 doses should receive 1 additional dose.

A single supplemental dose of PCV13 is recommended for all children in the following groups who were previously fully immunized with PCV7:

  • All healthy children aged 14-59 months old
  • All children aged 14-71 months with underlying medical conditions placing them at increased risk of pneumococcal disease
  • A single dose of PCV13 may be administered to children aged 6-18 years (regardless of previous pneumococcal immunization status) who are at increased risk of IPD because of sickle cell disease, asplenia, HIV/immunocompromise, CSF leaks, or cochlear implants. [73]

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