Pneumococcal Vaccine, Polyvalent

A to Z Drug Facts

 Action Induces antibodies against 23 capsular types of Streptococcus pneumoniae. Type-specific antibody facilitates bacterial destruction by complement-mediated lysis.

 Indications Protection against pneumococcal pneumonia, pneumococcal bacteremia, and other pneumococcal infections.

 Contraindications Patients with Hodgkin's disease who have received extensive chemotherapy or nodal irradiation; patients with Hodgkin's disease cannot have immunization < 10 days before or during chemotherapy; children < 2 yr. Some packages contain thimerosal as preservative; use cautiously in mercury-sensitive patients or choose different brand.

 Route/Dosage

ADULTS & CHILDREN: SC/IM 0.5 ml. Booster dose: Revaccinate recipients of 14-valent pneumococcal vaccine (distributed from 1977 to 1983) who are also at highest risk of fatal pneumococcal infection (eg, asplenic patients), using 23-valent vaccine. Revaccinate adults who received 23-valent vaccine 6 or more yr earlier if they are also at highest risk or are likely to have rapid decline in antibody levels (eg, patients with asplenia, patients with nephrotic syndrome, renal failure or transplant recipients). Consider revaccination of children with nephrotic syndrome, asplenia or sickle-cell anemia after 3 to 5 yr, if these children would be < 10 yr of age at time of revaccination.

 Interactions In patients anticipating immunosuppression, response to pneumococcal vaccine is best if administered 10 to 14 days prior to immunosuppressive chemotherapy or radiation. Pneumococcal and influenza vaccines and HIB, meningococcal and pneumococcal vaccines may safely and effectively be administered simultaneously at separate injection sites. As with other drugs administered by IM injection, give pneumococcal vaccine with caution to persons receiving anticoagulant therapy.

 Lab Test Interferences None well documented.

 Adverse Reactions Erythema and soreness at injection site, usually < 48 hr in duration. Local induration occurs less commonly. Rash, arthralgia, adenitis, fever > 39° C (102°F), malaise, myalgia and asthenia occur rarely. Low-grade fever (< 38.3°C or 100.9°F) occurs occasionally and usually subsides within 24 hr. Patients with otherwise stabilized immune thrombocytopenic purpura may rarely experience relapse in thrombocytopenia, 2 to 14 days after vaccination, lasting up to 2 wk. Anaphylactoid reactions have been rarely reported.

 Precautions

Pregnancy: Category C. Vaccinate if risk of disease outweighs risk to patients. Lactation: Undetermined.

 Administration/Storage

• Administer via SC or IM route only.
• Keep medication under refrigeration.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies. Note if patient is receiving immunosuppressive therapy or scheduled for surgery. Vaccine should be administered ³ 2 wk prior to these procedures when possible.
• If needed, give 1 dose of acetaminophen to reduce pain at injection site and to prevent fever.

 Patient/Family Education

• Instruct parents on risks and benefits of vaccination.
• Explain that tepid bath may reduce pain at injection site.
• Advise parents to complete all immunizations.
• Explain that low-grade fever is transient and should subside in 24 hr.
• Tell patient or parents to notify physician immediately if any serious adverse reactions occur (eg, shortness of breath, hives, wheezing).
• This vaccine is usually only needed once.

Books@Ovid
Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts