The Centers for Disease Control and Prevention (CDC) is urging health care professionals to vaccinate all individuals for whom PPSV vaccine is recommended to protect them from pneumococcal disease during this H1N1 influenza outbreak. Of special concern are persons with high-risk conditions for whom PPSV vaccine is recommended, but to whom the vaccine is rarely given. For example, in 2008, only 47% of Massachusetts adults 18 – 64 years of age with diabetes reported ever receiving pneumococcal vaccine.
CDC's Advisory Committee on Immunization Practices (ACIP) recommends a single dose of PPSV23 for all people 65 years and older and for persons 2 to 64 years of age with certain high-risk conditions. People in these groups are at increased risk of pneumococcal disease as well as serious complications from influenza.
A single revaccination at least five years after initial vaccination is recommended for people 65 years and older who were first vaccinated before age 65 years, as well as for people at highest risk, such as those who have no spleen, and those who have HIV infection, AIDS, or malignancy.
All people who have existing indications for PPSV23 should continue to be vaccinated according to current ACIP recommendations during the outbreak of novel influenza A (H1N1). Emphasis should be placed on vaccinating people aged younger than 65 years who have established high-risk conditions because PPSV23 coverage among this group is low and because people in this group appear to be overrepresented among severe cases of novel influenza A (H1N1) infection, based on currently available data.
Use of PPSV23 among people without current indications for vaccination is not recommended at this time. This recommendation may be revised as the epidemiology and clinical presentation of novel influenza A (H1N1) virus infection as well as the frequency and severity of secondary pneumococcal infections are better understood.
To read the entire document, including background about pneumococcal disease and PPSV and PCV vaccines, go to: http://www.cdc.gov/h1n1flu/guidance/ppsv_h1n1.htm
New Indications for PPSV
The ACIP recently released provisional recommendations recommending PPSV for all adults 19 – 64 years of age who smoke or who have asthma.
A new Vaccine Information Statement (VIS) for PPSV in English and other languages is available at http://www.immunize.org/vis/vis_ppsv.asp.
Availability of State-Supplied PPSV in Massachusetts
In Massachusetts, state-supplied pneumococcal polysaccharide vaccine is available for all Massachusetts children younger than 19 years of age with medical condition that are indications for PPSV, regardless of where they receive care; state-supplied PPSV is available for all Massachusetts adults seen at public sites who are 65 years of age and older, or 19 – 64 years of age with a medical indication for PPSV vaccination.
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