New recommendations for interval between pneumococcal conjugate vaccine Prevnar 13 and the pneumococcal polysaccharide vaccine Pneumovax 23

pneumococcal polysaccharide vaccinePneumonia occurs in the US and especially abroad.  So if you want to stay healthy or plan to travel, be sure you’re vaccinated against this disease.  Pneumococcal disease is more common in developing countries, is more common during winter and early spring but can occur year-round in the tropics.

Two pneumococcal vaccines are licensed for use in the United States: the pneumococcal conjugate vaccine (PCV13, Prevnar 13) and the pneumococcal polysaccharide vaccine (PPSV23, Pneumovax 23). The Advisory Committee on Immunization Practices (ACIP) currently recommends that “a dose of PCV13 be followed by a dose of PPSV23 in all adults aged ≥65 years who have not previously received pneumococcal vaccine and in persons aged ≥2 years who are at high risk for pneumococcal disease because of underlying medical conditions.”  The recommended intervals between PCV13 and PPSV23 given in series differ by age, risk group, and the sequence in which the two vaccines are given.

On June 25, 2015, ACIP changed the recommended interval for immunocompetent adults aged 65 years and older.  The new recommendation states that the interval between PCV13 followed by PPSV23 (PCV13–PPSV23 sequence), which was from 6–12 months, should be changed to 1 year or more.  ACIP also recommends that all adults aged 65 years and older who already received PPSV23 should receive a dose of PCV13  1 year  or more after receipt of PPSV23 (PPSV23–PCV13 sequence).  PCV13 is recommended before PPSV23, as this provides a better response to serotypes common to both vaccines.

The change was made because longer intervals between the use of the 2 different vaccines (e.g., ≥1 year) can lead to an improved immune response compared with a single dose of PCV13 or PPSV23.

ACIP Recommendations for Intervals Between PCV13 Followed by PPSV23 for Immunocompetent Adults Aged ≥65 Years

Immunocompetent adults aged 65 years and older who have not previously received pneumococcal vaccine should receive a dose of PPSV23 1 or more years following a dose of PCV13.   The two vaccines should not be co-administered.

If you already received PPSV23 when you were aged 65 or older, you should be administered PCV13 at least 1 year later.

If you are aged 65 and older and received PPSV23 vaccine before you were 65, you should be administered PCV13, followed by PPSV23 at least 1 year later.

There are no changes for other age and risk groups.

There are more than 90 types of pneumococcal bacteria. PCV13 can protect you against 13 of these strains, the ones most likely to cause you an infection.  If you ever had a life-threatening allergic reaction to this vaccine, to an earlier pneumococcal vaccine called PCV7 (or Prevnar), or to any vaccine containing diphtheria toxoid (for example, DTaP), you should not get PCV13. Anyone with a severe allergy to any component of PCV13 should not get the vaccine. Tell your doctor if you or the person being vaccinated has any severe allergies.

PPSV23 can protect you against 23 types of pneumococcal bacteria. If you had a life-threatening allergic reaction to PPSV, you should not get another dose. If you have a severe allergy to any component of PPSV, you should not receive it. Tell your healthcare provider if you have any severe allergies.  Children less than 2 years of age should not receive this vaccine.  Although there is no evidence that PPSV is harmful to either a pregnant woman or to her baby, women who need the vaccine should be vaccinated before becoming pregnant, if possible, according to the CDC.

All vaccines can cause side effects, but your healthcare provider can give you more information about how to best avoid reactions.

Pneumonia can be lethal.  Don’t let this disease hurt you, or prevent you from travelling. Get vaccinated.

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