A Clinician’s Handbook for Childhood & Adult Immunizations in Georgia

PPSV23®

Pathophysiology

  • Bacteria
  • Common inhabitant of the respiratory tract
  • Respiratory transmission: direct person-to- person via droplets or autoinoculation in persons carrying the bacteria in their upper respiratory tract.
  • Incubation period 1-3 days.

Vaccine Description

  • Inactivate vaccine indicated for active immunization for the prevention of pneumococcal disease caused by the 23 serotypes contained in the vaccine (1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F, and 33F)

Dose & Route

0.5 mL given IM or Subcut

Recommendations

Recommended for:

  • Adults ≥ 65 years of age.Adults aged ≥65 years who have not previously received PCV or whose previous vaccination history is unknown should receive 1 dose of PCV (either PCV20 or PCV15). When PCV15 is used, it should be followed by a dose of PPSV23.
  • Adults aged 19–64 years with certain underlying medical conditions or other risk factors. Adults aged 19–64 years with certain underlying medical conditions or other risk factors who have not previously received PCV or whose previous vaccination history is unknown should receive 1 dose of PCV (either PCV20 or PCV15). When PCV15 is used, it should be followed by a dose of PPSV23.
*High risk conditions:
  • Chronic illness (chronic cardiovascular disease, chronic pulmonary disease, diabetes mellitus, alcoholism, chronic liver disease, CSF leaks).
  • Functional or anatomic asplenia (Sickle cell disease, splenectomy).
  • Living in special environments or social settings (residents of nursing homes or long-term care facilities)
  • Immunocompromised persons (HIV infection, leukemia, lymphoma, Hodgkin’s disease, multiple myeloma, generalized malignancy, chronic renal failure, nephrotic syndrome, organ or bone marrow transplants, immunosuppressive chemotherapy and long-term corticosteroids).
  • Cochlear implant recipients.
  • Asthma or those who smoke cigarettes 19-64 years.

Administration Schedule

Clinical Guidance:

  • When PCV15 is used, the recommended interval between administration of PCV15 and PPSV23 is ≥1 year. A minimum interval of 8 weeks can be considered for adults with an immunocompromising condition, cochlear implant, or cerebrospinal fluid leak to minimize the risk for IPD caused by serotypes unique to PPSV23 in these vulnerable groups.
  • Adults with previous PPSV23 only. Adults who have only received PPSV23 may receive a PCV (either PCV20 or PCV15) ≥1 year after their last PPSV23 dose. When PCV15 is used in those with history of PPSV23 receipt, it need not be followed by another dose of PPSV23.
  • Adults with previous PCV13. The incremental public health benefits of providing PCV15 or PCV20 to adults who have received PCV13 only or both PCV13 and PPSV23 have not been evaluated. These adults should complete the previously recommended PPSV23 series.
  • Coadministration with other vaccines. PCV15, PCV20, or PPSV23 can be coadministered with QIV in an adult immunization program, as concomitant administration (PCV15 or PPSV23 and QIV [Fluarix], PCV20 and adjuvanted QIV [Fluad]) has been demonstrated to be immunogenic and safe. For adults who have received PCV13 but have not completed their recommended pneumococcal vaccine series with PPSV23, one dose of PCV20 may be used if PPSV23 is not available.

Contraindications

  • Anaphylactic reaction following a  prior dose of vaccine or vaccine component.
  • Defer vaccination in patients with  moderate or severe acute illness until illness subsides.
Download - PPSV23 Pdf