Children less than 18 years of age should receive Pneu-C-13 vaccine and Pneu-P-23 vaccine. Pneumococcal polysaccharide vaccine is less immunogenic in children than pneumococcal conjugate vaccine. Their use can prevent some cases of pneumonia, meningitis, and sepsis. Refer to Immunization of Persons with Inadequate Immunization Records in Part 3 for additional information about vaccination of people with inadequate immunization records. For additional information about S. pneumoniae, refer to the Public Health Agency of Canada (PHAC) website. National Advisory Committee on Immunization. Pneu-C-13 vaccine and Pneu-P-23 vaccine are recommended, followed by a booster dose of Pneu-P-23 vaccine. The Alberta Pharmacists’ Association has updated the influenza immunization education program for 2018/2019 which supports pharmacists in understanding the IIP. Refer to Table 3 and Table 4 for additional information. National Advisory Committee on Immunization. The pneumococcal vaccine protects against serious and potentially fatal pneumococcal infections. d�^ȃÖ����+M��A d��U2BL�v`F��j+�V?AW{c Mi��B Ț�*�A�_}s}ټ2�����d Some experts suggest a dose of pneumococcal conjugate vaccine followed by Pneu-P-23 vaccine for immunocompetent adults at high risk of IPD due to an underlying medical condition, as this may theoretically improve antibody response and immunologic memory. Refer to additional information contained within the product monograph available through Health Canada’s Drug Product Database. When considering immunization of an immunocompromised person with pneumococcal vaccines, consultation with the individual’s attending physician may be of assistance. The incubation period has not been clearly defined and may be as short as 1 to 3 days. Centers for Disease Control and Prevention. As of January 1, 2019, pharmacists will be able to provide routine Pneumococcal Polysaccharide 23 –Valent vaccine (Pneumo-P 23) to eligible adults 65 years of age and older. Refer to Immunocompromised persons for information about immunization of HSCT recipients. HSCT: hematopoietic stem cell transplant The case fatality rate of bacteremic pneumococcal pneumonia is 5% to 7% and is higher among elderly persons. Alberta Health has advised that the administration of the nasal flu mist may be submitted to the Alberta Health Care Insurance Plan as HSC 03.02A brief visit if the physician provides the service. Women who are breastfeeding can be vaccinated with pneumococcal vaccines. Adults should receive Pneu-P-23 vaccine. A new study has found severe pneumonia decreases by 35 per cent in children who receive a vaccine against a pneumonia-causing bacteria. Prematurity is associated with an increased risk of chronic lung disease which can increase the risk of IPD. Children at high risk of IPD due to an underlying medical condition should also receive 1 dose of Pneu-P-23 vaccine at 24 months of age. Vaccine providers are asked to report, through local public health officials, any serious or unexpected adverse event temporally related to vaccination. Pneumococcal vaccines may be administered concomitantly with other vaccines, with the exception of a different formulation of pneumococcal vaccine (i.e. A second dose of Pneu-P-23 vaccine is recommended for individuals of any age in whom antibody response is decreased due to: functional or anatomic hyposplenia or asplenia, including sickle cell disease; chronic liver disease, including hepatic cirrhosis; chronic kidney failure or nephrotic syndrome; and immunosuppression related to disease or therapy (i.e. 56 Specifically in Canada, hospitalization for all-cause and pneumococcal pneumonia has significantly declined in adults aged 65 years of age and older (P < .001), likely at least partially because of herd effects from the pediatric pneumococcal immunization program (which achieved 79.2% national coverage with 3 doses in 2013 57). Susceptibility to S. pneumoniae infection and IPD is increased in smokers, persons with alcoholism and illicit drug users. You may also get it if you have certain health problems. In many countries outside of Canada, pneumococcal conjugate vaccine is in limited use. The minimum interval between doses of pneumococcal conjugate vaccine is 8 weeks. concomitant use of Pneu-C-13 and Pneu-P-23). Deceuninck G, De Serres G, Boulianne N, Lefebvre B, De Wals P. Kellner JD, Church DL, MacDonald J, et al. Adults with immunocompromising conditions resulting in high risk of IPD, except HSCT, should receive 1 dose of Pneu-C-13 vaccine followed at least 8 weeks later by 1 dose of Pneu-P-23 vaccine, if not previously received. If you need both the PNEUMO-P and PNEU-C13 vaccines, it’s best to get the PNEU-C13 vaccine first. Refer to Storage and Handling of Immunizing Agents in Part 1 for storage and handling recommendations for pneumococcal vaccines. One dose of Pneu-P-23 vaccine should be administered to all individuals 24 months of age and older who are at. Anamnestic responses are induced upon boosting with either pneumococcal conjugate or Pneu-P-23 vaccines. The dose of Pneu-C-13 vaccine should be administered at least 1 year after any previous dose of Pneu-P-23 vaccine. Only one study by Riley et al ( Lancet. Pneu-P-23 vaccine may be given either IM or subcutaneously (SC). (U.S. Centre for Disease Control and Prevention) When both Pneu-C-13 and Pneu-P-23 vaccines are required, Pneu-C-13 vaccine should be provided first followed by Pneu-P-23 vaccine at least 8 weeks later. h�bbd``b`f׀�nKH0m�@��� D���6�D� Vs�7W"�}2$�h $�s@� �� C��2w&F�' F��6�0 ��i However, Pneu-P-23 vaccine is the vaccine of choice for these individuals. Immunization programs using a 3 dose schedule should offer the third dose at 12 months of age to allow for early complete protection. Refer to Table 3 and Table 4 for additional information. Abbreviations: Pneumococcal infections are caused by the bacterium Streptococcus pneumoniae and can lead to pneumonia, blood poisoning (sepsis) and meningitis. The pneumococcus is the leading cause of deadly pneumonia and kills nearly 400,000 children under age 5 each year, mostly in Africa and Asia. The CDC recommend the following schedules:. Individuals with malignant neoplasms, including leukemia and lymphoma and malignant solid tumours, should receive Pneu-C-13 vaccine and Pneu-P-23 vaccine, followed by a booster dose of Pneu-P-23 vaccine. Vaccination status for pneumococcal disease should be reviewed for immunocompetent persons who might be anticipating initiation of immunocompromising treatments, individuals on immunosuppressive therapy, and in those who have diseases that might lead to immunodeficiency. Refer to Contents of Immunizing Agents Available for Use in Canada in Part 1 for a list of vaccines available for use in Canada and their contents. Adults should receive Pneu-P-23 vaccine. Implementation - January 1, 2019 . Pneu-C-13 vaccine and Pneu-P-23 vaccine are recommended for individuals with immunocompromising conditions resulting in high risk of IPD. There are no studies comparing the immunogenicity of Pneu-C-10 and Pneu-C-13 vaccines. Humans carry S. pneumoniae in their nasopharynx. Serious adverse events are rare following immunization and, in most cases, data are insufficient to determine a causal association. Refer to Table 3 and Table 4 for additional information. The Public Health Agency of Canada urges everyone over 65 to get a pneumonia shot and it has set a national target of inoculating 80 percent of people within this age group. The flu, pneumonia and inflammation create a deadly threat Some experts also suggest a dose of Pneu-C-13 vaccine, followed by Pneu-P-23 vaccine, for immunocompetent adults with conditions resulting in high risk of IPD as this may theoretically improve antibody response and immunologic memory. Individuals who use illicit drugs should be considered for Pneu-P-23 vaccination. If this strategy is chosen, Pneu-C-13 vaccine should be administered first, followed at least 8 weeks later by Pneu-P-23 vaccine. endstream endobj startxref Influenza (Flu) vaccine. Adults should receive Pneu-P-23 vaccine. a safe and effective tool in preventing IPD in immunocompetent adults over 65 years of age People with diabetes mellitus should receive pneumococcal vaccine. The Pneu-C-13 vaccine dose should be administered at least 1 year after any previous dose of Pneu-P-23 vaccine. Adults at highest risk of IPD should also receive 1 booster dose of Pneu-P-23 vaccine; refer to Booster doses and re-immunization. What Streptococcus pneumoniae infections are a major cause of illness and death worldwide. Vaccines are offered free of charge to all Albertans older than six months. Refer to Table 3, Table 4 and Booster doses and re-immunization for additional information. Premature infants in stable clinical condition should be immunized with Pneu-C-13 vaccine at the same chronological age and according to the same schedule as full-term infants. Adults with nephrotic syndrome should receive Pneu-C-13 and Pneu-P-23 vaccine. Refer to Vaccine Administration Practices in Part 1 for additional information about pre-vaccination and post-vaccination counselling, vaccine preparation and administration technique, and infection prevention and control. However, Pneu-P-23 vaccine is the vaccine of choice for these individuals, and if only one vaccine can be provided, it should be Pneu-P-23 vaccine, because of the greater number of serotypes included in the vaccine. Pneu-C-7 vaccine provides a 54% reduction in AOM and a 20% reduction in tympanostomy (tube placement) due to infection with vaccine serotypes. Each dose of pneumococcal vaccine is 0.5 mL. Summary of Key Points WHO Position Paper on Pneumococcal conjugate vaccines in infants and children under 5 years of age–February 2019 Hyposplenic or asplenic individuals should receive Pneu-C-13 vaccine and Pneu-P-23 vaccine, followed by a booster dose of Pneu-P-23 vaccine. Individuals with cochlear implants, including children and adults who are to receive implants, should receive pneumococcal vaccine. The number of doses required to complete a vaccination series for children with interrupted or incomplete schedules varies with the age of the child. programmatic characteristics, vaccine supply, vaccine price, the local and regional prevalence of vaccine serotypes and antimicrobial resistance patterns. Adults with chronic kidney failure should receive Pneu-P-23 vaccine. Arthus-like reactions (causing a local vasculitis from deposition of immune complexes) are very rare and mainly occur in persons with high initial pneumococcal antibody concentrations. One dose of Pneu-P-23 vaccine is recommended for adults: 65 years of age and older, regardless of risk factors or previous pneumococcal vaccination. Refer to Immunization of Persons New to Canada in Part 3 for additional information about vaccination of people who are new to Canada. Refer to Table 3, Table 4 and Booster doses and re-immunization for additional information. A booster dose of Pneu-P-23 vaccine is recommended for people with chronic liver disease, including hepatic cirrhosis. The pneumonia shot is a vaccine that helps protect you against pneumococcal disease, or diseases caused by bacteria known as Streptococcus pneumoniae.The vaccine can help protect you … Pneu-P-23 vaccine efficacy is more than 80% against IPD among healthy young adults and ranges from 50% to 80% in the elderly and high-risk groups. There are two types of pneumococcal vaccines: conjugate vaccines and polysaccharide vaccines. Vaccine strategies for prevention of community-acquired pneumonia in Canada: Who would benefit most from pneumococcal immunization? Can Fam Physician. During outbreaks of pneumococcal infection due to Pneu-C-13 vaccine serotypes, immunization with Pneu-C-13 vaccine is recommended for children who have not been adequately immunized with Pneu-C-13 vaccine. As of January 1, 2019, pharmacists will be able to provide routine Pneumococcal Polysaccharide 23 – Valent vaccine (Pneumo-P 23) to eligible adults 65 years of age and older. The CDC has long recommended that in order to acquire the best protection against all strains of bacteria that cause pneumonia, all adults 65 and older should receive two pneumococcal vaccines: the pneumococcal conjugate vaccine (PCV13 or Prevnar 13) followed by the pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax) at a later visit. Pneu-P-23: pneumococcal polysaccharide 23-valent vaccine. For additional information about IPD in Canada, including disease description and distribution, refer to the PHAC invasive pneumococcal disease website. Although pneumococcal vaccines can be safely administered at any time before, during or after immunosuppressive therapy, vaccination should be timed so that optimal immunogenicity is achieved. %%EOF Infants born prematurely, especially those weighing less than 1,500 grams at birth, are at higher risk of apnea and bradycardia following vaccination compared to full-term infants. The tetanus, diphtheria and non-typeable Haemophilus influenzae carrier proteins used in pneumococcal conjugate vaccine do not confer protection against diphtheria, tetanus or Haemophilus influenzae type b (Hib) disease. It is an infection that can be caused by fungi, bacteria or viruses. It's also known as the pneumonia vaccine. Refer to Table 3, Table 4 and Booster doses and re-immunization for additional information. Pneu-P-23 or Pneu-C-13 vaccine can be used in adults, if the outbreak is due to serotypes included in the vaccine. Multiple re-vaccinations are not recommended; refer to Booster doses and re-immunization. Pneu-C-13 vaccine should be provided first followed by Pneu-P-23 vaccine at least 8 weeks later. Pneumococcal polysaccharide 23-valent (Pneu-P-23) vaccine efficacy against IPD is estimated to be 50% to 80% among the elderly and in high-risk groups. Bacterial spread within the respiratory tract may result in AOM, sinusitis or recurrent bronchitis. National Advisory Committee on Immunization. If an older child or adolescent at high risk of IPD due to an underlying medical condition has not previously received Pneu-P-23 vaccine, 1 dose of Pneu-P-23 vaccine should be administered, at least 8 weeks after Pneu-C-13 vaccine. For routine immunization of healthy infants, Pneu-C-13 vaccine may be provided using a 3 dose schedule at 2 months, 4 months and 12 months of age, or a 4 dose schedule at 2 months, 4 months and 6 months followed by a dose at 12 to 15 months of age. Administration of pneumococcal vaccine should be postponed in persons suffering from severe acute illness. Studies have suggested that re-vaccination after an interval of at least 4 years is not associated with an increased incidence of adverse side effects. A booster dose of Pneu-P-23 vaccine is not recommended. Individuals with chronic liver disease, including hepatic cirrhosis due to any cause, should receive pneumococcal vaccine. Regardless of age, pneumococcal vaccination should be started at 3 to 9 months after HSCT with 3 doses of Pneu-C-13 vaccine administered at least 4 weeks apart, followed by 1 dose of Pneu-P-23 vaccine 12 to 18 months post-transplant (6 to 12 months after the last dose of Pneu-C-13 vaccine) or when the HSCT recipient reaches 2 years of age. Alberta Health said all pharmacies should have received the vaccine by Oct. 21. Refer to Immunocompromised persons for recommendations for HSCT recipients. A second dose of Pneu-C-13 vaccine is not necessary because there is currently no evidence that a booster dose is beneficial. Refer to Table 3 and Table 4 for additional information. Infants immunized with Pneu-C-7 vaccine develop a 3.4-fold to 20-fold increase in serum antibodies against vaccine serotypes. Worldwide, pneumococcal disease is a major cause of morbidity and mortality. Refer to Table 3, Table 4 and Booster doses and re-immunization for additional information. routine immunization of infants and children, immunization of children who missed pneumococcal immunization on the routine schedule, immunization of residents of long-term care facilities, immunization of adults who are at high risk of IPD due to lifestyle factors: smokers, persons with alcoholism, persons who are homeless, immunization of all adults 65 years of age and older, Pneumococcal vaccine should be considered for adults who use illicit drugs. This fact sheet outlines the eligibility criteria for the vaccine and reporting requirements for pharmacists. Pneumococcal vaccines are contraindicated in persons with a history of anaphylaxis after previous administration of the vaccine and in persons with proven immediate or anaphylactic hypersensitivity to any component of the vaccine. At least 8 weeks after any previous dose of Pneu-C-13 vaccine and at least 5 years after any previous dose of Pneu-P-23 vaccine. Medicare Coverage for the Pneumonia Vaccine. There may be redness, swelling and soreness at the injection site following pneumococcal immunization. Refer to Immunization of Adults in Part 3 for additional information about routinely recommended immunization for adults as well as vaccines recommended for adults in specific risk situations. Children and adolescents at highest risk of IPD should receive 1 booster dose of Pneu-P-23 vaccine; refer to Booster doses and re-immunization. Studies of Pneu-C-13 vaccine indicated that irritability; decreased appetite; increased or decreased sleep; and pain, swelling and redness at the injection site; after the toddler dose and in older children, are common side effects. Refer to Recommendations for Use for information about pneumococcal vaccination of individuals at increased risk of IPD. Children and adults lacking adequate documentation of immunization should be considered unimmunized and should be started on an immunization schedule appropriate for their age and risk factors. Re-immunization of healthy adults less than 2 years after the initial dose is associated with increased injection site and systemic reactions. One booster dose of Pneu-P-23 vaccine is recommended for people at highest risk of IPD; refer Booster doses and re-immunization. Immunocompetent adults with conditions or lifestyle factors (smokers, persons with alcoholism and homeless persons) resulting in high risk of IPD should receive 1 dose of Pneu-P-23 vaccine, if not previously received. Like any vaccine, Prevnar 13 may not provide protection from disease in every person. Refer to Immunization of Travellers in Part 3 for additional information about vaccination of travellers. This includes: • heart, lung, kidney, or liver problems • diabetes a weak immune system • all adults age 65 years and older If you need both thePNEU-C13 and PNEUMO -P vaccines, it is best to get the PNEU-C13 vaccine first. Immunization with Pneu-C-13 vaccine may be considered on an individual basis for pneumococcal vaccine-naïve adults aged 65 years and older for the prevention of CAP and IPD caused by the 13 pneumococcal serotypes included in the vaccine. There were six cases in 2018. Refer to Immunocompromised persons for information about immunization of HSCT recipients. Re: Pneumococcal Polysaccharide 23 –Valent V accine: Pneumovax® 23 Pharmacy Enhanced Immunization Services Program . One dose of Pneu-C-13 vaccine should be considered for other healthy children. Payment allowances and effective dates for the 2019-2020 flu season, is available on the Centers for Medicare & Medicaid Services Seasonal Influenza Vaccines Pricing page. With Covid in our midst, can I have a Prevnar 13 Vaccine and then 8 weeks later at Pneumonia 23 vaccine? Refer to Timing of Vaccine Administration in Part 1 for additional information about delayed immunization schedules and accelerated immunization schedules. Eligibility Criteria: Comprehensive updates on the epidemiology of IPD in Canada are published periodically in the Canadian Communicable Disease Report. In adults over 50 years of age, the most commonly reported side effects included pain at the injection site, fatigue, headache and new onset of myalgia, with fever above 38°C occurring in approximately 3% of vaccine recipients. Because antibody response to pneumococcal vaccination is known to be poor in HSCT recipients, HSCT recipients over 2 years of age should receive a booster dose of Pneu-P-23 vaccine 1 year after the initial dose of Pneu-P-23 vaccine. If indicated, pregnant women can be vaccinated with Pneu-P-23 vaccine or Pneu-C-13 vaccine, as there is no evidence to suggest a risk to the fetus or to the pregnancy from immunization with pneumococcal vaccines. People 65 and older are particularly at risk because as we age, our immune system isn't able to fight off these infections. There are currently no data available regarding the safety of pneumococcal conjugate vaccine for children less than 6 weeks of age. A booster dose of Pneu-P-23 vaccine is not recommended. TUESDAY, Feb. 3, 2015 (HealthDay News) -- Adults 65 and older need two vaccines to better protect them from bacterial infection in the blood (called sepsis), meningitis and pneumonia… A meta-analyses shows no decrease in pneumonia incidence as a result of vaccination, however it has been shown to be about 60-70% effective in preventing invasive disease (meningitis, bacteremia). They are given by injection either into a muscle or just under the skin.. People with HIV infection should receive Pneu-C-13 vaccine and Pneu-P-23 vaccine, followed by a booster dose of Pneu-P-23 vaccine. For enquiries, contact us. Last complete chapter revision (see Table of Updates): October 2016. Immunization should not be delayed because of minor acute illness, with or without fever. 2019-2020 flu, pneumococcal, and hepatitis B vaccine reimbursement Vaccine fees. At their worst, they can cause permanent brain damage, or even kill. We work to broaden access to the two commercially available pneumococcal conjugate vaccines (PCVs) while also investing in the development, regulatory approval, and deployment of newer and improved vaccines. The bacterium Streptococcus pneumoniae is the cause of invasive pneumococcal disease (IPD) and a common cause of community acquired pneumonia (CAP). Generally asplenia (functional or anatomic), sickle cell disease and other hemoglobinopathies are not considered immunocompromising conditions, but for the purposes of pneumococcal vaccine recommendations they are included in this category. However, like any medicine, Prevnar 13 can cause side effects but the risk of serious side effects is extremely low. Refer to Timing of Vaccine Administration in Part 1 for additional information about concurrent administration of vaccines. According to Alberta Health Services, there have been no reported cases of measles in the province in 2019. Reactions to Pneu-P-23 vaccine are usually mild. Refer to Immunization of Persons with Chronic Diseases in Part 3 for additional information about vaccination of people with chronic diseases. Significant revisions included in this chapter are highlighted in the Table of Updates to the Canadian Immunization Guide. Individuals with chronic heart disease should receive age appropriate pneumococcal vaccines. HSCT recipients over 2 years of age should receive a booster dose of Pneu-P-23 vaccine 1 year after the initial dose of Pneu-P-23 vaccine. �_e��&(q��X�c�.yĀ=n�wIJ9���м�d;]bd*��ev��LVV���Տ��I{P�. Pneumococcal conjugate vaccine (PNEU-C13) is another type of pneumococcal vaccine. Follow relevant provincial or territorial schedule. Pneumococcal conjugate vaccine should be administered intramuscularly (IM). My dad had a pneumonia shot in 2019. Studies on Pneu-C-10 vaccine demonstrated an antibody response to all 10 vaccine serotypes. IPD: invasive pneumococcal disease If only one vaccine can be provided, it should be Pneu-P-23 vaccine. Studies on Pneu-C-13 vaccine demonstrated an antibody response to all 13 vaccine serotypes. There should be at least an 8 week interval between a dose of pneumococcal conjugate vaccine and a subsequent dose of Pneu-P-23 vaccine, and at least a 1 year interval between a dose of Pneu-P-23 vaccine and a subsequent dose of pneumococcal conjugate vaccine; refer to Immunocompromised persons for information regarding administration of pneumococcal vaccines to HSCT recipients. Infants who are less than 12 months of age when they re-present should complete their immunization schedule as if no interruption had occurred. Refer to Immunization in Pregnancy and Breastfeeding in Part 3 for additional information about vaccination of women who are pregnant or breastfeeding. American Academy of Pediatrics. Refer to Immunization of Infants Born Prematurely in Part 3 for additional information about vaccination of premature infants. 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