| DIALOG/PROGRESS NOTE TEXT |
{FLD:IM PNEUMOCOCCAL VACCINE NCP GUIDANCE}
* Which adults should receive PPSV23 (Pneumovax)?
All those age 65 and older
Ages 19-64 if they are a smoker, live in long-term care facility,
chronic lung, heart, liver or kidney disease (nephrotic syndrome,
CKD III-V or renal failure), diabetes, alcoholism, have
immunocompromising conditions, nephrotic syndrome, CKD Stages
III, IV or V, renal failure, functional or anatomic asplenia, CSF
leaks, or cochlear implants
{FLD:IM PNEUMOCOCCAL VACCINE ALGORITHM}
* How many doses of PPSV23 (Pneumovax) should be given and when should
they be given?
One dose for those ages 19-64 with any indications listed above
A second dose 5 years later if ages 19-64 for those have
immunocompromising conditions, nephrotic syndrome, CKD Stage
III, IV or V, renal failure, functional or anatomic asplenia
One dose at or after age 65 for all patients, regardless of
diagnoses (five years after any prior dose)
* Can PPSV23 (Pneumovax) and PCV13 (Prevnar 13) be given on the same day?
No (see below for time delay needed between these two vaccines,
which is different depending on which vaccine was given first)
* If a patient needs both PPSV23 (Pneumovax) and PCV13 (Prevnar 13), which
vaccine should be given first? \\
PCV13 (Prevnar 13) should be given first. For adults 64 and younger,
PPSV23 (Pneumovax) has been recommended for some adults since 1997.
or for patients who are immunocompromised, wait at least 8 weeks
after a dose of PCV13 (Prevnar 13) before giving PPSV23
(Pneumovax). For adults 65 and older who are not immunocompromised,
wait at least 12 months after a dose of PCV13 before giving PPSV23.
PCV13 and PPSV23 should not be co-administered. If a dose of PPSV23
is inadvertently given before the recommended time interval, it
does not need to be repeated. This clinical reminder automatically
waits the correct amount of time if a prior dose of PCV13 (Prevnar
13) is on file at this medical center. If patient received PCV13
(Prevnar 13 ) somewhere else document that. For adults 64 and
younger or for immunocompromised patients, if the date of PCV13
administration is at least 8 weeks in the past, PPSV23 can be
given. For adults 65 and older who are not immunocompromised, if
the date of PCV13 administration is at least 1 year in the past,
PPSV23 can be given.
PCV13 (Prevnar 13) is a different vaccine and newly recommended for
some adults starting in 2013 and for all adults ages 65 and older
beginning in 2014. There is a separate clinical reminder for PCV13
(Prevnar 13)
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