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Prevention

Vaccine

The best way to prevent pneumococcal disease is to vaccinate your patients.

The pneumococcal conjugate vaccine (PCV13 or Prevnar 13®) provides protection against the 13 serotypes responsible for most severe illness in children. The vaccine can also help prevent some ear infections. PCV13 is administered as a four-dose series at 2, 4, 6, and 12 through 15 months of life. It has been shown to be very effective in preventing infection resulting from the serotypes contained in the vaccine. PCV13 should also be administered to some adults with immunocompromising conditions.

The pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax 23®) is a 23-valent polysaccharide vaccine that is currently recommended for use in all adults who are 65 years and older and for persons who are 2 years and older and at high risk for disease. It is also recommended for use in adults 19 through 64 years of age who smoke cigarettes or who have asthma.

It’s also important to administer an influenza vaccination every year because having the flu increases your patient’s chances of getting pneumococcal disease.

For more information on who should get a pneumococcal vaccine, see the ACIP recommendations.

Before routine use of pneumococcal conjugate vaccine, the burden of pneumococcal disease among children younger than 5 years of age was significant.

  • An estimated 17,000 cases of invasive disease occurred each year, of which 13,000 were bacteremia without a known site of infection and about 700 were meningitis.
  • An estimated 200 children died every year as a result of invasive pneumococcal disease.
  • Although not considered invasive disease, an estimated 5 million cases of acute otitis media occurred each year among children younger than 5 years of age.
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Chemoprophylaxis

For children with functional or anatomic asplenia, especially those with sickle-cell disease, daily antimicrobial prophylaxis with oral penicillin V or G is typically recommended. In general, antimicrobial prophylaxis (in addition to immunization) should be considered for all children with asplenia younger than 5 years of age and for at least 1 year after splenectomy.

Because secondary cases of invasive pneumococcal infection are uncommon, chemoprophylaxis is not indicated for contacts of patients with such infection.


References

American Academy of Pediatrics. Children with asplenia or functional asplenia. In: Pickering LK, Baker CI, Kimberlin DW, Long SS, eds. Red Book: 2009 Report of the Committee on Infectious Diseases, 28th ed. Elk Grove Village, IL; 2009:72.

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