Pneumococcal vaccine changes key in 2013 adult immunization schedule


Recommended use of several vaccines, including pneumococcal conjugate vaccine (PCV13), pneumococcal polysaccharide vaccine (PPSV23), and Tdap vaccine, are updated in the 2013 adult immunization schedule, issued by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices. The schedule was published online Jan. 28 in Morbidity and Mortality Weekly Report.

PCV13 is now recommended for adults 19 years and older who have immunocompromising conditions such as chronic renal failure, functional or anatomic asplenia, cerebrospinal fluid leaks, or cochlear implants.

Two doses of PPSV23 given before age 65 now are recommended for patients with certain conditions. For those who have received two doses before age 65, the vaccine is still recommended, as long as it has been 5 years since the most recent dose (MMWR 2013;62:1-19).

Individuals not vaccinated with PCV13 or PPSV23 should receive a single dose of PCV13, followed by a dose of PPSV23 at least 8 weeks apart. If already vaccinated with PPSV23, they should receive PCV13 vaccination 1 year or more later.

The tetanus, diphtheria, and acellular pertussis (Tdap) vaccine is now recommended as routine for adults 65 years and older (one dose), and for pregnant women during 27 to 36 weeks’ gestation, regardless of the interval since prior Td/Tdap vaccination.

The zoster vaccine is now recommended for adults starting at age 60 years, with or without underlying health conditions, as long the vaccines is not contraindicated for them.

The complete schedule and footnotes can be found here.

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