Pneumococcal Vaccine Recommendations Published

Troy Brown

October 12, 2012

October 12, 2012 — An advisory committee to the Centers for Disease Control and Prevention has released recommendations on the use of 13-valent pneumococcal conjugate vaccine (PCV13; Prevnar 13, Wyeth Pharmaceuticals Inc, a subsidiary of Pfizer Inc) and 23-valent pneumococcal polysaccharide vaccine (PPSV23; Pneumovax 23, Merck & Co Inc) in adults with immunocompromising conditions, according to an article published in the October 12 issue of the Morbidity and Mortality Weekly Report.

These recommendations follow a June 20 meeting at which the Advisory Committee on Immunization Practices voted 14 to 1 in favor of recommending the addition of PCV13 to PPSV23 for adults with immunocompromising conditions.

The committee recommends vaccinating "[a]dults with specified immunocompromising conditions who are eligible for pneumococcal vaccine...with PCV13 during their next pneumococcal vaccination opportunity."

New guidelines for vaccination of pneumococcal vaccine-naive persons include:

  • "[A]dults aged ≥19 years with immunocompromising conditions, functional or anatomic asplenia, [cerebrospinal] leaks, or cochlear implants, and who have not previously received PCV13 or PPSV23, should receive a dose of PCV13 first, followed by a dose of PPSV23 at least 8 weeks later."

  • "Subsequent doses of PPSV23 should follow current PPSV23 recommendations for adults at high risk. Specifically, a second PPSV23 dose is recommended 5 years after the first PPSV23 dose for persons aged 19–64 years with functional or anatomic asplenia and for persons with immunocompromising conditions."

  • "[T]hose who received PPSV23 before age 65 years for any indication should receive another dose of the vaccine at age 65 years, or later if at least 5 years have elapsed since their previous PPSV23 dose."

Guidelines for patients with previous vaccination with PPSV23 include:

  • "Adults aged ≥19 years with immunocompromising conditions, functional or anatomic asplenia, [cerebrospinal fluid] leaks, or cochlear implants, who previously have received ≥1 doses of PPSV23 should be given a PCV13 dose ≥1 year after the last PPSV23 dose was received."

  • "For those who require additional doses of PPSV23, the first such dose should be given no sooner than 8 weeks after PCV13 and at least 5 years after the most recent dose of PPSV23."

The authors have disclosed no relevant financial relationships.

Morb Mortal Wkly Rep. 2012;61:816-819. Full text