Pneumococcal vaccine 23-valent

Because patient with SCD have impaired splenic function, they are less adequately protected against encapsulated organisms such as S. pneumoniae, Hemophilus influenzae, and Salmonella. The use of pneumococcal vaccine in SCD patients has decreased the rates of morbidity and mortality dramatically. However, there are still groups of SCD children who continue to have high rates of invasive pneumococcal infections.17 Two pneumococcal vaccines are available. The 7-valent conjugate... 

There are two pneumococcal vaccines, a 7-valent conjugated vaccine for children younger than 6 years of age and a 23-purified-capsular polysaccharide antigen vaccine for adults. The 23 capsular types in the vaccine represent at least 85% to 90% of the serotypes that cause invasive pneumococcal infections among children and adults in the United States.41 After vaccination, an antigen-specific antibody response, indicated by a twofold or greater rise in serotype-specific antibody, develops within 2 to 3 weeks in 80% or more of healthy young adults.42... 

Prevnar Pneumococcal 7-valent conjugate vaccine Lederle laboratories Immunization to prevent invasive pneumococcal disease... 

Pneumococcal Disease In October 2002, the FDA approved the use of Prevnar for immunization of infants and toddlers against otitis media— middle ear infection. Prevnar is a pneumococcal seven-valent conjugate vaccine. It is formulated with a sterile solution of saccharides conjugated to the antigen, Streptococcus pneumoniae. 

Measles, Mumps, Rubella, Varicella Virus Vaccine, Live [MMRV] (Proquad) Meningococcal Conjugate Vaccine (Menactra) Meningococcal Polysaccharide Vaccine (Menomune A/C/YAV-135) Pneumococcal 7-Valent Conjugate Vaccine (Prevnar)... 

Pneumococcal 7-Valent Conjugate Vaccine (Prevnar) [Vaccine]... 

Pneumococcal 7-valent conjugate vaccine (diphtheria CRM197 protein)... 

Prevenar [TR former used prior to approval] Pneumococcal 7-valent conjugate vaccine (diphtheria CRM197 protein) [FDA] PncCRM [SY]... 

Pneumococcal vaccine is composed of a saline solution containing the purified capsular polysaccharides of 23 types of Streptococcus pneumoniae. The improved 23-valent vaccine, which replaced a 14-valent vaccine at the beginning of the 1980s, contains antigens to pneumococcal types that are responsible for about 85% of bacteremic pneumococcal pneumonia. 

The immunogenicity of 7-valent pneumococcal-conjugate vaccine plus 23-valent pneumococcal vaccine in 11 children has been compared with the immunogenicity of 23-valent vaccine alone in 12 children up to 2 years of age with sickle cell disease (9). IgG pneumococcal antibody concentrations were higher with combined administration, with no increase in adverse effects after immunization with 23-valent vaccine. 

An allergic reaction has been described to 23-valent polysaccharide pneumococcal vaccine (17). 

A 2-year-old child developed bronchospasm and cutaneous and laryngeal edema immediately after the injection of a 23-valent polysaccharide pneumococcal vaccine. The sjmptoms resolved within 1 hour of treatment with antihistamines, glucocorticoids, and aerosols. Skin tests and specific IgE tests showed that the pneumococcal antigens were responsible for the anaphylaxis. 

Vernacchio L, Neufeld EJ, MacDonald K, Kurth S, Murakami S, Hohne C, King M, Molrine D. Combined schedule of 7-valent pneumococcal conjugate vaccine followed by 23-valent pneumococcal vaccine in children and young adults with sickle cell disease. J Pediatr 1998 133(2) 275-8. 

Ponvert C, Ardelean-Jaby D, Colin-Gorski AM, Soufflet B, Hamberger C, de Blic J, Scheinmann P. Anaphylaxis to the 23-valent pneumococcal vaccine in child a case-control study based on immediate responses in skin tests and specific IgE determination. Vaccine 2001 19(32) 4588-91. 

Clinicians administering vaccines covered by the NCVIA are protected against litigation surrounding possible vaccine-related adverse events.Pharmacists are commonly involved with the administration of pneumococcal 23-valent and influenza virus vaccines—vaccines not currently covered by the NCVIA. Despite this, pharmacists should be familiar with this far-reaching legislation and understand both the ramifications and limitations on vaccine coverage. 

Two different pneumococcal vaccines are available. The 7-valent pneumococcal conjugate vaccine (PCV 7 Prevnar) induces good antibody responses in infants. Immunization with the PCV 7 is recommended for all children less than 24 months of age. Infants should receive the first dose between 6 weeks and 6 months. Two additional doses should be given at approximately 2-month intervals, followed by a fourth dose at age 12 to 15 months. The 23-valent pneumococcal polysaccharide vaccine (PPV 23 Pneumovax 23) was not recommended for use in children less than 2 years of age because... 

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-... 

Prevnar 13 Pneumococcal 13-valent Conjugate Vaccine (Diphtheria CRM 197 Protein)... 

The vaccine is both cost effective and protective against invasive pneumococcal infection when administered to immunocompetent persons aged 2 years or older. Therefore, all persons in the following categories should receive the 23-valent pneumococcal polysaccharide vaccine (Table 2). If earlier vaccination status is unknown, persons in these categories should be given pneumococcal vaccine. 

Routine revaccination of immunocompetent persons previously vaccinated with 23-valent polysaccharide vaccine is not recommended. However, revaccination once is recommended for persons at least 2 years old who are at highest risk for serious pneumococcal infection and those who are likely to have a rapid decline in pneumococcal antibody levels, provided that 5 or more years have elapsed since receipt of the first dose of pneumococcal vaccine. Revaccination 3 years after the previous dose may be considered for children at highest risk for severe pneumococcal infection who would be 10 years old or younger at the time of revaccination. These children include those with functional or anatomical asplenia (e.g., sickle cell disease or splenectomy) and those with conditions associated with rapid antibody decline after initial vaccination (e.g.. 

Type B vaccine, the Neisseria meningitidis Type A and C vaccine, the 23-valent pneumococcal polysaccharide vaccine and an acellular typhoid vaccine. 

PCV 7, 7-valent pneumococcal conjugated vaccine PPV 23, 23-valent pneumococcal polysaccharide vaccine. From Advisory Committee on Immunization Practices,18 Committee on Infectious Diseases,16 and Sickle Cell Disease Care Consortium.27... 

Centers for Disease Control and Prevention. Direct and indirect effects of routine vaccination of children with 7-valent pneumococcal conjugate vaccine on incidence of invasive pneumococcal disease—United States, 1998-2003. Morbidity and Mortality Weekly Report (MMWR) 2005 54(36) 893-897. 

Herd immunity refers to high levels of immunization in one population resulting in protection of another unvaccinated population. For example, concentrated vaccination of children with the 7-valent pneumococcal conjugate vaccine resulted in decreased invasive Streptococcus pneumoniae infection not only in the vaccinated children, but also in elderly persons within the same community. 

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