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Ask the AIPO Experts
Clinical answers to vaccine questions
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Special Vaccine Schedules
Pediatric Pneumococcal Vaccines
Besides the routine pediatric pneumococcal conjugate vaccine (PCV13) schedule, there are special circumstances when additional PCV13 and/or pneumococcal polysaccharide (PPSV23) vaccines are recommended.
Age 2–5 years of age
Chronic heart disease, chronic lung disease (including asthma treated with high-dose, oral corticosteroids), diabetes mellitus, cerebrospinal fluid leaks, and cochlear implant(s):
- Give 2 doses of PCV13 if they are unvaccinated or received an incomplete PCV13 series with <3 doses. Give the second dose at least 8 weeks after the first.
- Give 1 dose of PCV13 if they received 3 doses of PCV13 but none were given after 12 months of age.
- Give 1 dose of PPSV23 at least 8 weeks after the PCV13 series is complete.
Sickle cell disease and other hemoglobinopathies, anatomic or functional asplenia, congenital or acquired immunodeficiency, HIV infection, chronic renal failure or nephrotic syndrome, iatrogenic immunosuppression including radiation therapy, leukemia or lymphoma, Hodgkin disease, generalized and metastatic malignancies, and solid organ transplantation:
- Give 2 doses of PCV13 if they are unvaccinated or received an incomplete PCV13 series with <3 doses. Give the second dose at least 8 weeks after the first.
- Give 1 dose of PCV13 if they received 3 doses of PCV13 but none were given after 12 months of age.
- Give 2 doses of PPSV23 after the PCV13 series is complete. Give the first PPSV23 dose at least 8 weeks after any prior PCV13 dose, then give the second dose of PPSV23 at least 5 years after the first PPSV23 dose.
Age 6–18 years of age
Chronic heart disease, chronic lung disease including chronic obstructive pulmonary disease, emphysema, and asthma (if treated with high-dose oral corticosteroid therapy), and diabetes mellitus:
- Give 1 dose of PPSV23 (if not already given earlier in childhood).
Cochlear implant and cerebrospinal fluid leak:
- Give 1 dose of PCV13 if they have not received any doses of PCV13. Administer PCV13 before giving any recommended doses of PPSV23.
- Give 1 dose of PPSV23 (if not already given earlier in childhood) at least 8 weeks after PCV13.
Sickle cell disease and other hemoglobinopathies, anatomic or functional asplenia, congenital or acquired immunodeficiency, HIV infection, chronic renal failure or nephrotic syndrome, iatrogenic immunosuppression including radiation therapy, leukemia or lymphoma, Hodgkin disease, multiple myeloma, and generalized and metastatic malignancies, and solid organ transplantation:
- Give 1 dose of PCV13 if they have not received any doses of PCV13. Administer PCV13 before giving any recommended doses of PPSV23.
- Ensure the child receives 2 doses of PPSV23. The first dose of PPSV23 should be given at least 8 weeks after any prior PCV13 dose, then the second dose of PPSV23 should be given at least 5 years after the first dose of PPSV23.
>>When both PCV13 and PPSV23 are indicated, administer PCV13 first separated by the appropriate minimum interval. PCV13 and PPSV23 should not be administered during same visit.<<
The AIPO has clinical staff available to assist with your immunization questions (or your county health department).
Main Desk: 602-364-3630, ask for a nurse consultation.
Michelina Stazzone, DNP, RN, CPNP Michelina.stazzone@azdhs.gov, 480-259-5342
Sharon Sweeney, MPH, BSN Sharon.sweeney@azdhs.gov, 480-261-5557
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