VA-PNEUMOCOCCAL IMMUNIZATION PCV13 (1599)    REMINDER DEFINITION (811.9)

Pneumococcal vaccine-nave persons. ACIP recommends that adults aged >=19 
for adults at high risk. Specifically, a second PPSV23 dose is recommended
5 years after the first PPSV23 dose for persons aged 19-64 years with
functional or anatomic asplenia and for persons with immunocompromising
conditions. Additionally, those who received PPSV23 before age 65 years
for any indication should receive another dose of the vaccine at age 65
years, or later if at least 5 years have elapsed since their previous
PPSV23 dose. 
 
Previous vaccination with PPSV23. Adults aged >=19 years with 
immunocompromising conditions, functional or anatomic asplenia, CSF 
years with immunocompromising conditions, functional or anatomic 
leaks, or cochlear implants, who previously have received >=1 doses of 
PPSV23 should be given a PCV13 dose >=1 year after the last PPSV23 dose 
was received. For those who require additional doses of PPSV23, the first 
such dose should be given no sooner than 8 weeks after PCV13 (age <65 or 
immunocompromised) or no sooner than 1 year after PCV13 (age 65 or older 
and not immunocompromised) and at least 5 years after the most recent dose
of PPSV23. 
 
If meningococcal conjgate vaccine (diphtheria conjugate) is given, then 
PCV13 administration should be delayed 4 weeks due to possible reduced 
asplenia, CSF leaks, cochlear implants or age 65 and older, and who have
antibody response.
not previously received PCV13 or PPSV23, should receive a dose of PCV13
first, followed by a dose of PPSV23 at least 8 weeks later if age <65 or 
immunocompromised and at least 1 year later if age 65 or older AND not 
immunocompromised.
 
Subsequent doses of PPSV23 should follow current PPSV23 recommendations

• LOGIC:   FN(1)>FN(2)
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• LOGIC:   (FN(1)>0)!(FN(2)>0)!(FN(3)>0)!(FN(4)>0)
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• LOGIC:   ((FN(1)>0))&'(((FN(2)="INTRAVITREAL")!(FN(3)="INTRAVITREAL")!(FN(2)="TOPICALLY")!(FN(3)="TOPICALLY")))
  FUNCTION STRING:   ((VALUE(11,1,"START DATE")>0))&'(((VALUE(11,1,"MR")="INTRAVITREAL")!(VALUE(11,1,"MEDICATION ROUTE")="INTRAVITREAL")!(VALUE(11,1,"MR")="TOPICALLY")!(VALUE(11,1,"MEDICATION ROUTE")="TOPICALLY")))
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• LOGIC:   ((FN(1)>0))&'(((FN(2)="INTRAVITREAL")!(FN(3)="INTRAVITREAL")!(FN(2)="TOPICALLY")!(FN(3)="TOPICALLY")))
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• URL:   http://www.cdc.gov/vaccines/vpd-vac/pneumo/vac-PCV13-adults.htm
  WEB SITE TITLE:   CDC Information on PCV13 for Adults
• URL:   http://www.cdc.gov/vaccines/hcp/vis/vis-statements/pcv13.html
  WEB SITE TITLE:   PCV 13 (Prevnar) Vaccine Information Statement (VIS)
• URL:   http://immunize.us1.list-manage1.com/track/click?u=69948816469e0f4801f8647ee&id=d7eea44b5d&e=b8d57ee9b5
  WEB SITE TITLE:   CDC Recommendations on use of PCV13 for Adults (Oct 2012)
• URL:   http://vaww.prevention.domain.ext/Pneumococcal_Immunization.asp
  WEB SITE TITLE:   VHA Pneumococcal Immunization Guidance Statement
• URL:   http://vaww.prevention.domain.ext/docs/PneumococcalImmunizationsAlgorithm.pdf
  WEB SITE TITLE:   Pneumococcal Immunization Algorithm for PPSV23 and PCV13