Prevnar 20
- For adults who have not been previously vaccinated with a pneumococcal vaccine, NACI recommends that a single dose of Prevnar®20 should be offered to:
- Adults 65 years of age and over
- Adults 50 to 64 years of age living with factors that place them at higher risk of pneumococcal disease
- Adults 18 to 49 years of age with immunocompromising conditions
- As a discretionary recommendation, NACI recommends:
- A single dose of Vaxneuvance® followed by a single dose of Pneumovax®23 may be offered as an alternative to Prevnar®20
- For adults 18-49 years of age with non-immunocompromising risk factors, Prevnar®20 and Vaxneuvance® may be considered at clinical discretion.
- For adults who have previously received a pneumococcal vaccine, NACI recommends that a single dose of Prevnar®20:
- Should be offered to adults 65 years of age and over who have received Pneumovax®23 alone or both Prevnar®13 and Pneumovax®23, if it has been at least 5 years since the last dose of a pneumococcal vaccine.
- As a discretionary recommendation, NACI recommends that a single dose of Prevnar®20:
- May be offered to adults 65 years of age and over who have received Prevnar®13 alone, if it has been 1 year since the last dose of Prevnar®13
- For adults who have received a hematopoietic stem cell transplant (HSCT), see the full statement (linked below) for additional recommendations.
Pneumococcal Vaccine (Pneumovax 23) *covered +65
Indication
- >65 yrs old
- > 2 yrs old with following conditions;
- chronic heart, kidney or lung disease (except asthma);
- nephrotic syndrome;
- chronic liver disease, including cirrhosis of the liver;
- alcoholism;
- diabetes mellitus;
- chronic cerebral spinal fluid leak;
- HIV;
- other diseases or therapy that suppress the immune system;
- no spleen or a spleen that does not work properly;
- sickle cell disease;
- solid organ or islet cell transplant;
- cochlear implants;
- neurologic conditions that may impair clearance of oral secretions;
- stem cell transplant (HSCT) and;
- residents of nursing homes, homes for the aged and chronic care facilities or wards.
Prevnar 13 *covered for high risk
Prevnar 13 (13 strains vs 23 strains); usually only given to children. If you didn’t receive as a child, get Prevnar 13 then Pneumovax 23 one year later. Not a covered vaccine by ODB.
In some cases, the CDC recommends that adults get Prevnar 13 in addition to Pneumovax 23. If a person has any of the following conditions, they are considered at high risk for a serious pneumococcal infection, and need both vaccines:
- A cerebrospinal fluid leak
- A cochlear implant
- A spleen that doesn’t work well or no spleen
- Sickle cell disease or other inherited blood disorder
- HIV infection
- Chronic kidney failure
- Nephrotic syndrome
- Cancer of the blood (leukemia, lymphoma, Hodgkin disease, multiple myeloma)
- Metastatic cancer (cancer that has spread beyond the original location)
- Organ transplantation
- Anyone who has been told that their immune system is weaker than normal
- Anyone who takes medications that lower your immune system (including long-term steroid use and radiation therapy)
- Some providers will also recommend both vaccines if a person has had a serious invasive pneumococcal infection in the past.
Shingles
Indication : 65 – 70 yrs old