PPRNet Practice Guidelines

Pneumococcal Vaccine 

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Practice guideline:

Vaccine in the following patients:

• At least 65 years of age or older

• Comorbidities of diabetes, COPD, heart disease (CHD or CHF), chronic renal disease, or alcohol abuse

Pneumococcal vaccine is recommended for the following patients:

• Persons Aged greater than or equal to 65 Years
  All persons in this category should receive the pneumococcal vaccine, including previously unvaccinated persons and persons who have not received vaccine within 5 years (and were less than 65 years of age at the time of vaccination). All persons who have unknown vaccination status should receive one dose of vaccine.
  
• Persons Aged 2-64 Years Who Have Chronic Illness or Functional or Anatomic Asplenia
  Persons aged 2-64 years who are at increased risk for pneumococcal disease or its complications if they become infected should be vaccinated. Persons at increased risk for severe disease include those with chronic illness such as chronic cardiovascular disease (e.g., HF or cardiomyopathy), chronic pulmonary disease (e.g., COPD or emphysema, but not asthma), diabetes mellitus, alcoholism, chronic liver disease (cirrhosis), CSF leaks, and functional or anatomic asplenia.

Routine revaccination is not recommended at this time, although a one-time revaccination should be considered in high-risk patients age 2-64 years if at least 5 years have passed since their initial immunization. Data from studies of the duration of pneumococcal antibody response are pending and may objectively delineate what patient groups should be revaccinated and how frequently.

Additional resources:

Prevention of Pnuemococcal Disease: Recommendations of the Advisory Committee on Immunization Practices