Polysaccharide Pneumococcal Vaccine

Adults: Primary vaccination Adults and children aged 2 years or older get one single dose of 0.5 milliliter of Polysaccharide Pneumococcal Vaccine, given by intramuscular or subcutaneous injection. The vaccine is not recommended for children below 2 years of age, because its safety and efficacy have not been established and the antibody response may be poor. Special dosing The pneumococcal vaccine should preferably be given at least two weeks before elective splenectomy, or before chemotherapy or other immunosuppressive treatment is started. Vaccination during chemotherapy or radiation therapy should be avoided. After chemotherapy and/or radiation therapy for neoplastic disease is completed, immune responses to vaccination may remain diminished. So the vaccine should not be given any sooner than three months after such therapy ends. A longer delay may be appropriate for patients who have had intensive or prolonged treatment. People with asymptomatic or symptomatic HIV infection should be vaccinated as soon as possible once the diagnosis is confirmed. Revaccination The dose is again one single dose of 0.5 milliliter by intramuscular or subcutaneous injection. The exact timing of revaccination, and whether it is needed at all, should be decided on the basis of available official recommendations. Revaccination at an interval of less than three years is not recommended because the risk of adverse reactions is higher. Local reactions, and in people aged ≥65 years some systemic reactions, have been shown to occur at higher rates after revaccination than after primary vaccination when three to five years have passed between doses. Adults Healthy adults should not be revaccinated routinely. Revaccination may be considered for people at increased risk of serious pneumococcal infection who were given pneumococcal vaccine more than five years earlier, or for those known to have a rapid decline in pneumococcal antibody levels. For selected populations (e.g., asplenics) known to be at high risk of fatal pneumococcal infections, revaccination at three years may be considered. Children Routine revaccination is not advised for healthy children. Those of 10 years of age and over may be considered for revaccination according to the adult recommendation. For the age group between 2 and 10 years, revaccination should only be considered after 3 years, and only if the child is at high risk of pneumococcal infection (e.g., those with nephrotic syndrome, asplenia or sickle cell disease).