Pneumoccocal vaccine for older adults 2021 update By Linus Lay
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The document discusses pneumococcal vaccination recommendations for adults. It provides information on two main pneumococcal vaccines, PCV13 and PPSV23, including their costs, effectiveness against invasive pneumococcal disease (IPD) and non-IPD, and common side effects. It then presents a decision tree outlining recommendations for pneumococcal vaccination in adults based on their age, medical conditions, and vaccination history. The tree provides guidance on determining which vaccines individuals should receive and the timing of doses.
![Linus Lay 8/11/21
Pharm. D Candidate URI Class of 2022
“Pneumococcal Disease.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 1 Sept. 2020,
www.cdc.gov/pneumococcal/index.html.
Musher, Daniel M. Pneumococcal vaccination in adults. In: UpToDate, Post TW (Ed), UpToDate, WalthamMA. (Accessed on August 1, 2021.)
Tuomanen, Elaine I. Pneumococcal vaccination in children. In: UpToDate, Post TW (Ed), UpToDate, WalthamMA. (Accessed on Augu st 1, 2021.)
Ages 19-64 Ages >65
Vaccines Cost
(CASH)
Protection rate
(Age >65)
Side
effects
Prevnar 13
(PCV13)
$263 47-59% IPD
38-70% non-IPD
6-11% all-cause
pneumonia
Pain at
injection,
fatigue,
headache,
chills, rash
Pneumovax 23
(PPSV23)
$146 60-70% IPD
(32-37%
IPD from 11
serotypes)
[IPD= invasive
pneumococcal disease]
Pain at
injection,
headache,
fatigue,
muscle
pain
For all ages (with
medical condition)
unless a severe allergic
reaction or current
severe illness
For the prevention
of the bacterial
infection S.
pneumoniae
(Pneumonia)
Pneumococcal Vaccine
for Adults (>18)
Does patient have at least one
condition:
Chronic heart, lung, or liver disease
Diabetes
Alcoholism
Current smoker
YES
NO
Does patient have at least one of the following:
Cochlear implants
CSF Leaks
Functional/Anatomic Asplenia
Immunocompromised/immunodeficient
YES
NO
GIVE
PCV13 &
PPSV23
(Follow
Guidelines
below*)
No vaccine
until age 65
Had PPSV23 within past 10 years?
YES NO
1 dose of PPSV23
No vaccine until next 10 years
Cochlear implants,
CSF leaks, asplenia,
immunocompromised
No history of
PPSV23,
PCV13, or
unknown
Received
PPSV23
after age
65
Received
PPSV23
before 65
years old
Received
PCV13
prior to 65
years old
Give PCV13(?) Give PPSV23 Give
PPSV23
>1 yr after
PCV13
>5 yrs after
last PPSV23
PCV13 (?)
1 yr after
last
PPSV23
PPSV23
1 yr later
PCV13 (?)
1 yr later
PCV13
IF no
history
Give PPSV23
>8 weeks after PCV13
>5 yrs after last
PPSV23
No history of PPSV23, PCV13
1 previous PPSV23 dose
2 previous PPSV23 doses
1 previous PCV13 dose
Give PCV13
Give PCV13 >1yr after PPSV23
Give PCV13 >1yr after PPSV23
Give PPSV23
>8 weeks after PCV13,
Revaccinate PPSV23
>5 yrs after 1st PPSV23
Give 1 PPSV23 at age >65;
>5 yrs apart from last dose
What is Pneumococcal
vaccine for?
Who qualifies for the
vaccine?
TRY CDC
PneumoRecs APP for
easy vaccine
scheduling!
Patient has no medical condition or at least one of the following:
Chronic heart, lung, or liver disease, diabetes, alcoholism, smoker](https://image.slidesharecdn.com/appecommunitypneumoccocalvaccine-211107194206/85/pneumoccocal-vaccine-for-older-adults-2021-update-by-linus-lay-1-320.jpg)
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Pneumoccocal vaccine for older adults 2021 update By Linus Lay
- 1. Linus Lay 8/11/21 Pharm. D Candidate URI Class of 2022 “Pneumococcal Disease.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 1 Sept. 2020, www.cdc.gov/pneumococcal/index.html. Musher, Daniel M. Pneumococcal vaccination in adults. In: UpToDate, Post TW (Ed), UpToDate, WalthamMA. (Accessed on August 1, 2021.) Tuomanen, Elaine I. Pneumococcal vaccination in children. In: UpToDate, Post TW (Ed), UpToDate, WalthamMA. (Accessed on Augu st 1, 2021.) Ages 19-64 Ages >65 Vaccines Cost (CASH) Protection rate (Age >65) Side effects Prevnar 13 (PCV13) $263 47-59% IPD 38-70% non-IPD 6-11% all-cause pneumonia Pain at injection, fatigue, headache, chills, rash Pneumovax 23 (PPSV23) $146 60-70% IPD (32-37% IPD from 11 serotypes) [IPD= invasive pneumococcal disease] Pain at injection, headache, fatigue, muscle pain For all ages (with medical condition) unless a severe allergic reaction or current severe illness For the prevention of the bacterial infection S. pneumoniae (Pneumonia) Pneumococcal Vaccine for Adults (>18) Does patient have at least one condition: Chronic heart, lung, or liver disease Diabetes Alcoholism Current smoker YES NO Does patient have at least one of the following: Cochlear implants CSF Leaks Functional/Anatomic Asplenia Immunocompromised/immunodeficient YES NO GIVE PCV13 & PPSV23 (Follow Guidelines below*) No vaccine until age 65 Had PPSV23 within past 10 years? YES NO 1 dose of PPSV23 No vaccine until next 10 years Cochlear implants, CSF leaks, asplenia, immunocompromised No history of PPSV23, PCV13, or unknown Received PPSV23 after age 65 Received PPSV23 before 65 years old Received PCV13 prior to 65 years old Give PCV13(?) Give PPSV23 Give PPSV23 >1 yr after PCV13 >5 yrs after last PPSV23 PCV13 (?) 1 yr after last PPSV23 PPSV23 1 yr later PCV13 (?) 1 yr later PCV13 IF no history Give PPSV23 >8 weeks after PCV13 >5 yrs after last PPSV23 No history of PPSV23, PCV13 1 previous PPSV23 dose 2 previous PPSV23 doses 1 previous PCV13 dose Give PCV13 Give PCV13 >1yr after PPSV23 Give PCV13 >1yr after PPSV23 Give PPSV23 >8 weeks after PCV13, Revaccinate PPSV23 >5 yrs after 1st PPSV23 Give 1 PPSV23 at age >65; >5 yrs apart from last dose What is Pneumococcal vaccine for? Who qualifies for the vaccine? TRY CDC PneumoRecs APP for easy vaccine scheduling! Patient has no medical condition or at least one of the following: Chronic heart, lung, or liver disease, diabetes, alcoholism, smoker