This page offers a brief an introduction of guidance for administering pneumococcal vaccines, including route, variety of doses, and also co-administration with various other vaccines.

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intuitive Inspection

Do not use any kind of pneumococcal vaccine beyond the expiration day printed on the label.

Prior come administration, visually examine the vaccine for particulate issue and/or discoloration. If these conditions exist, execute NOT use.

Route, Site, and Needle Size

Administer pneumococcal polysaccharide vaccine (PPSV23) intramuscularly or subcutaneously. Carry out pneumococcal conjugate vaccine (PCV13) intramuscularly. The wanted site for infants and young children is the vastus lateralis muscle in the anterolateral thigh. The desired injection site in older children and also adults is the deltoid muscle. Use a needle length ideal for the age and size that the person receiving the vaccine.

Number and also Timing that Doses

Vaccinate all youngsters younger 보다 2 year old v PCV13. The primary collection consists that 3 sheep routinely given at 2, 4, and also 6 month of age. You can carry out the an initial dose as early as 6 mainly of age. proposal a 4th (booster) sheep at 12 v 15 month of age. For youngsters vaccinated as soon as they space younger 보다 12 months of age, the minimum interval between doses is 4 weeks. Separate doses given at 12 month of age and also older by at least 8 weeks.

The number and timing of doses for older children and also adults relies on the clinical indication, front pneumococcal vaccination, and also age. View Pneumococcal Vaccination: an overview of Who and When to Vaccinatefor all pneumococcal vaccine referrals by vaccine and also age.

Pneumococcal Vaccine Timing

Predrawing Vaccine Doses

There space no data top top the stability of vaccines save in syringes to fill by healthcare professionals. Therefore, does not recommend predrawing vaccine doses. Perform not open up vaccine vials until time of administration.

management with other Vaccines

Never carry out PCV13 and PPSV23 throughout the exact same visit. If a patient requirements both vaccines, girlfriend should carry out PCV13 first, complied with by PPSV23 at an additional visit. The expression between administrations depends ~ above the age of the patient, the point out for offering it, and also which vaccine you provide first. Watch the table listed below for extr information.

interval between vaccine managements by ageAge GroupInterval Recommendation(PCV13 then PPSV23, preferred)Interval Recommendation(PPSV23 climate PCV13)
24 through 71 month olds with particular medical conditions*8 mainly or longer8 weeks or longer
6 through 18 year olds with certain medical conditions*8 main or longer8 mainly or longer
19 or older with certain medical conditions*8 mainly or longer1 year or longer
65 or olderand immunocompetent (i.e., no medical conditions listed below*)1 year or longer1 year or longer

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* Medical conditions include cochlear implants, cerebrospinal fluid leaks, sensible or anatomic asplenia, and also immunocompromising conditions like HIV infection, cancer, or chronic renal failure.

For Children

You can carry out PCV13 or PPSV23 at the exact same time as many other routine childhood vaccinations, with one exception.

Do not provide PCV13 with Menactra®, a meningococcal conjugate vaccine. Youngsters with functional or anatomic asplenia or HIV need to NOT receive Menactra® prior to the age of 2 years. This timing prevents interference through the immunologic response to the infant series of PCV13. recommends babies 2 with 23 month of period with sensible or anatomic asplenia or HIV obtain Menveo®.

Giving influenza vaccine through PCV13 rises the threat for febrile seizures in kids according to a Vaccine security Datalink study. However, made no changes in the recommendations; clinicians may offer these vaccines at the same time. The examine looked in ~ trivalent inactivated influenza vaccine (TIV or IIV) and PCV13 for the 2006–07 through 2010–2011 influenza seasons and the 2014–15 season. The findings showed that PCV13 and also diphtheria, tetanus, and acellular pertussis vaccine (DTaP) both increase risk of febrile seizure when provided at the same time together the influenza vaccine. uncovered that administering TIV alone was not associated with an boosted risk the febrile seizures (in the influenza periods studied).

There are no recognized adverse results on immunogenicity or safety as soon as administering PCV13 simultaneously with vaccines containing the adhering to antigens:

Diphtheria, tetanus, or acellular pertussisHaemophilus influenzae kind bInactivated poliomyelitisRotavirusHepatitis BMeningococcal serogroup CMeasles, mumps, rubella, or varicella

Currently, no data from clinical trials are easily accessible for co-administration that PPSV23 with other childhood vaccines throughout the exact same visit.

For Adults

In adults, friend can provide either pneumococcal vaccine (PCV13 or PPSV23) throughout the exact same visit v influenza vaccination. Administer each vaccine with a different syringe and, if feasible, at a different injection site. Yearly influenza inoculation is essential to assist prevent the flu. Additionally, since having the flu rises the threat of obtaining pneumococcal disease, receiving a flu vaccine is essential for staying clear of pneumococcal disease.

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A randomized double-blind trial through adults 65 year or older uncovered that concomitant management of PCV13 and also TIV produced a diminished immune an answer for part pneumococcal serotypes and one influenza subtype (influenza A ) contrasted to individuals who obtained PCV13 alone or TIV alone. However, studies show concomitant management of PCV13 and also TIV is immunogenic and safe. Friend can administer PCV13 throughout the very same visit v TIV in an adult immunization program.Currently, no data are easily accessible on administration of PCV13 during the exact same visit with other vaccines (e.g., tetanus, diphtheria, and also acellular pertussis vaccine or zoster vaccine) among adults.A randomized clinical study uncovered that concomitant management of PPSV23 and zoster vaccine created a diminished immune response to zoster compared with individuals who received these vaccines 4 mainly apart. However, to prevent introducing barriers to vaccination, continues to recommend management of zoster vaccine and PPSV23 at the exact same visit if the human is eligible because that both vaccines.

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