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Pneumovax 23
pneumococcal 23-valent polysaccharide vaccine (PPSV23)
Adult Dosing .
Dosage forms: INJ
invasive pneumococcal disease prevention
- [no or unknown pneumococcal vaccine history]
- Dose: 0.5 mL SC/IM x1; Info: for patients 65 yo and older and high-risk patients <65 yo; give at least 8wk after last PCV15 dose in patients with cochlear implant, CSF leak, or immunocompromised patients, otherwise give at least 1y after last PCV13 or PCV15 dose; search 'immunization' for epocrates Adult Immunization decision tool including links to CDC/ACIP schedules
- [previously received PCV7 only]
- Dose: 0.5 mL SC/IM x1; Info: for patients 65 yo and older and high-risk patients <65 yo; give at least 8wk after last PCV15 dose in patients with cochlear implant, CSF leak, or immunocompromised patients, otherwise give at least 1y after last PCV13 or PCV15 dose; search 'immunization' for epocrates Adult Immunization decision tool including links to CDC/ACIP schedules
- [previously received PCV13 only, <65 yo, patients with chronic conditions]
- Dose: 0.5 mL SC/IM x1; Start: >1y after last PCV13 dose; Info: search 'immunization' for epocrates Adult Immunization decision tool including links to CDC/ACIP schedules
- [previously received PCV13 only, <65 yo, patients with cochlear implant or CSF leak]
- Dose: 0.5 mL SC/IM x1; Start: >8wk after last PCV13 dose; Info: search 'immunization' for epocrates Adult Immunization decision tool including links to CDC/ACIP schedules
- [previously received PCV13 only, <65 yo, immunocompromised patients]
- Dose: 0.5 mL SC/IM x2 doses >5y apart; Start: >8wk after last PCV13 dose; Info: search 'immunization' for epocrates Adult Immunization decision tool including links to CDC/ACIP schedules
- [previously received PCV13 only, 65 yo and older]
- Dose: 0.5 mL SC/IM x1; Start: >1y after last PCV13 dose; Info: give >8wk after last PCV13 dose in patients with cochlear implant, CSF leak, or immunocompromised patients; search 'immunization' for epocrates Adult Immunization decision tool including links to CDC/ACIP schedules
- [previously received PCV13 and PPSV23, <65 yo, immunocompromised patients]
- Dose: 0.5 mL SC/IM x1; Start: >5y after last PPSV23 dose and >8wk after last PCV13 dose; Info: search 'immunization' for epocrates Adult Immunization decision tool including links to CDC/ACIP schedules
- [previously received PCV13 and PPSV23, 65 yo and older]
- Dose: 0.5 mL SC/IM x1; Info: for patients who received PPSV23 at <65 yo; give at least 5y after last PPSV23 dose; give at least 8wk after last PCV13 dose in patients with cochlear implant, CSF leak, or immunocompromised patients, otherwise give at least 1y after last PCV13 dose; search 'immunization' for epocrates Adult Immunization decision tool including links to CDC/ACIP schedules
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [no adjustment]
Peds Dosing .
- Dosage forms: INJ
invasive pneumococcal disease prevention
- [2 yo and older at series start, patients with chronic conditions]
- Dose: 0.5 mL SC/IM x1; Start: >8wk after last PCV13 or PCV15 dose; Info: search 'immunization' for epocrates Child/Adolescent Immunization decision tool including links to CDC/ACIP schedules
- [2 yo and older at series start, patients with CSF leak or cochlear implant]
- Dose: 0.5 mL SC/IM x1; Start: >8wk after last PCV13 or PCV15 dose; Info: search 'immunization' for epocrates Child/Adolescent Immunization decision tool including links to CDC/ACIP schedules
- [2 yo and older at series start, immunocompromised patients]
- Dose: 0.5 mL SC/IM x2 doses at least 5y apart; Start: >8wk after last PCV13 or PCV15 dose; may give PCV20 instead of 2nd PPSV23 dose; Info: search 'immunization' for epocrates Child/Adolescent Immunization decision tool including links to CDC/ACIP schedules
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [no adjustment]
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- caution: immunocompromised patients
- caution: illness, acute moderate-severe
- caution: CSF leakage, chronic
Drug Interactions .
Overview
pneumococcal vaccine
vaccine
- non-live vaccine
Avoid/Use Alternative
Monitor/Modify Tx
Adverse Reactions .
Serious Reactions
- hypersensitivity reaction
- radiculopathy
- Guillain-Barre syndrome
- cellulitis
- thrombocytopenia with prior stable immune thrombocytopenia
- hemolytic anemia (patients with prior hematologic disorders)
Common Reactions
- injection site reaction
- headache
- asthenia
- fatigue
- myalgia
- rigors
- fever
- nausea
- vomiting
- arthralgia
- rash
Safety/Monitoring .
Monitoring Parameters
no routine tests recommended
Look/Sound-Alike Drug Names
Pneumovax 23 confused with: Prevnar
pneumococcal vaccine polyvalent confused with: pneumococcal conjugate vaccine
pneumococcal vaccine, 23-valent confused with: pneumococcal vaccine, 7-valent; pneumococcal vaccine, 13-valent; pneumococcal vaccine, 15-valent; pneumococcal vaccine, 20-valent
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; risk of fetal harm not expected based on limited human data
Lactation
Clinical Summary
may use while breastfeeding; no human data available, though risk of infant harm not expected based on vaccine properties; no human data available to assess effects on milk production
Pharmacology .
Metabolism: for pneumococcal vaccine: other; CYP450: unknown
Excretion: for pneumococcal vaccine: other; Half-life: unknown
Subclass: Pneumococcal Vaccines ; Routine Adult Vaccines ; Routine Pediatric Vaccines
Mechanism of Action
for pneumococcal vaccine: exact mechanism of action unknown; induces antibody formation
Formulary .
No Formulary Selected
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