Alerts

CDC Interim Guidelines: Use of 23-Valent Pneumococcal Polysaccharide Vaccine During 2009 H1N1 Influenza Outbreak - Updated November 2009

The Centers for Disease Control and Prevention (CDC) has provided interim guidance on which groups should be vaccinated using the 23-valent pneumococcal polysaccharide vaccine (PPSV23) during the 2009 H1N1influenza outbreak. Pneumococcal vaccines may be useful in preventing secondary pneumococcal infections during influenza outbreaks. Influenza predisposes patients to bacterial community-acquired pneumonia and was an important factor of illness and death associated with the 20th century influenza pandemic. Pneumococcal infections have also been an important complication among severe cases (eg, requiring hospitalization) of the current H1N1 outbreak.

The CDC’s Advisory Committee on Immunization Practices (ACIP) recommends a single dose of PPSV23 be given to the following patient populations due to their increased risk of pneumococcal disease and from suffering complications arising from influenza infection:

• 1) All patients ≥65 years of age
• 2) Patients 2-64 years of age with certain high-risk condition(s):
  • Chronic cardiovascular disease (heart failure and cardiomyopathies)
  • Chronic pulmonary disease (including COPD and emphysema)
  • Diabetes mellitus
  • Alcoholism
  • Chronic liver disease (including cirrhosis)
  • Cerebrospinal fluid leaks
  • Cochlear implants
  • Functional or anatomic asplenia (including sickle cell disease and splenectomy)
  • Immunocompromising conditions (including HIV infection, leukemia, lymphoma, Hodgkin’s disease, multiple myeloma, generalized malignancy, chronic renal failure, nephrotic syndrome; patients receiving immunosuppressive chemotherapy, including corticosteroids; patients who have received an organ or bone marrow transplant).
  • Residents of nursing homes or long-term care facilities
• 3) Adults aged 19-64 years of age who smoke cigarettes or have asthma

PPSV23 vaccination, including revaccination, should continue during the present H1N1 outbreak according to current ACIP recommendations for patients with existing indications. At present, the CDC is not recommending vaccination using PPSV23 in patients without existing ACIP recommended indications.

Of note, the 7-valent pneumococcal conjugate vaccine (PCV7) is recommended for use in children <5 years of age; however, expanding the use of PCV7 to patients ≥5 years is not recommended due to the declining circulation of the 7 serotypes included in this vaccine.

Recommendations may change or be revised as more information concerning the clinical impact of the novel influenza A (H1N1) virus becomes available. For the most recent recommendations, please refer to:http://www.cdc.gov/h1n1flu/guidance/ppsv_h1n1.htm (October 26, 2009)

U.S. Brand Names

• Pneumovax® 23

Medication Safety Issues

Sound-alike/look-alike issues:

• Pneumococcal 23-Valent Polysaccharide Vaccine (Pneumovax® 23) may be confused with Pneumococcal 7-Valent Conjugate Vaccine (Prevnar®) or with Pneumococcal 13-Valent Conjugate Vaccine (Prevnar 13™)

Generic Available

No

Pharmacologic Categories

• Vaccine, Inactivated (Bacterial)

Related Terms

• 23-Valent Pneumococcal Polysaccharide Vaccine
• 23PS
• PPSV
• PPSV23
• PPV23

Available Products

Image	Description
	Brand Name Pneumovax® 23 Strength 25 mcg each of 23 capsular polysaccharide isolates/0.5 mL Labeler Merck and Co Inc Class Rx Route for injection NDC 000064739
	Brand Name Pneumovax® 23 Strength 25 mcg each of 23 capsular polysaccharide isolates/0.5 mL Labeler Merck and Co Inc Class Rx Route for injection NDC 000064943