Pneumococcal vaccines Immunosuppressants

Pneumococcal Vaccine, Polyvalent (Pneumovox-23) [Vaccine/ Inactive Bacteria] Uses Immunization against pneumococcal Infxns in pts at high risk (eg, all = 65 y of age) Action Active immunization Dose 0.5 mL EM. Caution [C, ] Contra Do not vaccinate during immunosuppressive thCTapy Disp Inj SE Fever, inj site Rxn, hemolytic anemia, thromboc5rtopenia, anaphylaxis Interactions Effects W/ corticosteroids, immunosuppressants EMS None OD ... 

Appropriate immunizations should be a primary consideration in the prevention of infections in HSCT recipients. Immunizations against common bacterial and viral pathogens are timed to avoid periods of severe immunosuppression following HSCT when the protective response to vaccination potentially would be decreased. Current recommendations for immunization of HSCT patients include three doses each of diphtheria-pertussis-tetanus or diphtheria-tetanus, inactivated polio, conjugated H. influenzae type b, and hepatitis B vaccines at 12, 14, and 24 months after transplantation. The 23-valent pneumococcal vaccine should be administered at 12 and 24 months after HSCT, and the influenza vaccine should be administered prior to HSCT, resumed at least 6 months after transplantation, and con-... 

Prevention of infection in the transplant patient can be accomplished in a number of ways. First, risk of environmental contamination should be minimized. Patients should be protected from institutional infectious outbreaks. Transplant patients should receive the pneumococcal vaccine once and the influenza vaccine yearly however, their immunologic responses to these vaccines may be blunted by immunosuppressive therapy. ... 

Dengler TJ, Strnad N, Buhring I, et al. Differential immune response to influenza and pneumococcal vaccination in immunosuppressed patients after heart transplantation. Transplantation 1998 66 1340-1347. 

Good responses to pneumococcal vaccines in patients taking immunosuppressant drugs after organ transplantation have been seen, but protee-tive antibody titres may not persist as long as in healthy subjeets. ... 

The 23-valent pneumococcal polysaccharide vaccine is recommended for use in all adults 65 years of age or older and adults less than 65 years who have medical comorbidities that increase the risk for serious complications from S. pneumoniae infection, such as chronic pulmonary disorders, cardiovascular disease, diabetes mellitus, chronic liver disease, chronic renal failure, functional or anatomic asplenia, and immunosuppressive disorders. Alaskan natives and certain Native American populations are also at increased risk. Children over the age of 2 years may be vaccinated with the 23-valent pneumococcal polysaccharide vaccine if they are at increased risk for invasive S. pneumoniae infections, such as children with sickle cell anemia or those receiving cochlear implants. 

For children up to age 16 years with HTV infection, immunization following the standard schedules is recommended for hepatitis B, DTaP, pneumococcal conjugate vaccine (PCV7), H. influenzae type b (Hib), inactivated polio vaccine (IPV), and annual influenza. Two doses of MMR vaccine should be administered at least 1 month apart as soon as possible after the first birthday. MMR should be administered only to children who have no evidence or moderate evidence of immunosuppression. Two doses of varicella vaccine separated by... 

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