What is PPSV23. How does it prevent pneumococcal disease. Who should receive the vaccine. What are the potential side effects. How effective is PPSV23 in protecting against pneumococcal infections.

Understanding Pneumococcal Disease and Its Impact

Pneumococcal disease encompasses a range of illnesses caused by Streptococcus pneumoniae bacteria. These infections can vary from mild to severe, potentially leading to life-threatening conditions. The most common manifestations include:

• Pneumonia (lung infection)
• Otitis media (ear infections)
• Sinusitis (sinus infections)
• Meningitis (infection of the brain and spinal cord membranes)
• Bacteremia (bloodstream infection)

While anyone can contract pneumococcal disease, certain groups face higher risks. These include children under 2 years old, adults 65 and older, individuals with specific medical conditions, and cigarette smokers. The severity of pneumococcal infections can range from mild to severe, with some cases resulting in long-term complications or even death.

PPSV23: A Powerful Tool in Pneumococcal Disease Prevention

PPSV23, or Pneumococcal Polysaccharide Vaccine 23-valent, is a crucial weapon in the fight against pneumococcal disease. This vaccine offers protection against 23 different types of pneumococcal bacteria, which are responsible for the majority of pneumococcal infections.

How does PPSV23 work?

PPSV23 stimulates the immune system to produce antibodies against the 23 most common pneumococcal serotypes. When exposed to these bacteria in the future, the body can mount a rapid and effective immune response, preventing infection or reducing its severity.

Who should receive PPSV23?

The Centers for Disease Control and Prevention (CDC) recommends PPSV23 for:

• All adults aged 65 and older
• Individuals 2 years and older with certain medical conditions that increase their risk of pneumococcal disease
• Adults 19-64 years old who smoke cigarettes

It’s important to note that most people only need one dose of PPSV23 in their lifetime. However, certain high-risk groups may require a second dose or additional pneumococcal vaccines, such as PCV13.

The Vaccination Process: What to Expect

Getting vaccinated with PPSV23 is a straightforward process, but it’s essential to be prepared and informed. Here’s what you can expect:

Before the vaccination

Inform your healthcare provider about any allergies, previous vaccine reactions, or current illnesses. While minor illnesses like colds don’t usually prevent vaccination, moderate to severe illnesses may require postponing the shot.

During the vaccination

PPSV23 is administered as an intramuscular injection, typically in the upper arm. The process is quick and usually causes minimal discomfort.

After the vaccination

You may experience some mild side effects, such as:

• Redness or pain at the injection site
• Fatigue
• Low-grade fever
• Muscle aches

These symptoms typically resolve within a few days. Severe reactions are rare but can occur. If you notice signs of a severe allergic reaction, such as difficulty breathing or swelling of the face and throat, seek immediate medical attention.

Efficacy and Limitations of PPSV23

PPSV23 has proven to be an effective tool in preventing pneumococcal disease. However, it’s important to understand both its strengths and limitations.

How effective is PPSV23?

Studies have shown that PPSV23 is approximately 60-70% effective in preventing invasive pneumococcal disease caused by the serotypes included in the vaccine. Its effectiveness may vary depending on factors such as age, underlying health conditions, and the specific type of pneumococcal infection.

What are the limitations of PPSV23?

While PPSV23 offers protection against 23 serotypes of pneumococcal bacteria, it does not cover all possible strains. Additionally, the vaccine’s effectiveness may decrease over time, particularly in older adults or those with weakened immune systems.

Potential Side Effects and Safety Considerations

Like all medical interventions, PPSV23 can have side effects. However, serious adverse reactions are rare, and the benefits of vaccination generally outweigh the risks for recommended individuals.

Common side effects

Most side effects associated with PPSV23 are mild and short-lived. They may include:

• Soreness, redness, or swelling at the injection site
• Low-grade fever
• Fatigue
• Muscle pain

Rare but serious side effects

While extremely uncommon, severe allergic reactions can occur. Symptoms of a severe allergic reaction may include:

• Difficulty breathing
• Swelling of the face and throat
• Rapid heartbeat
• Dizziness or weakness

If you experience any of these symptoms after vaccination, seek immediate medical attention.

PPSV23 and Other Pneumococcal Vaccines: Understanding the Differences

PPSV23 is not the only pneumococcal vaccine available. Another important vaccine is PCV13 (Pneumococcal Conjugate Vaccine 13-valent). Understanding the differences between these vaccines can help you make informed decisions about your pneumococcal disease prevention strategy.

PPSV23 vs. PCV13

The main differences between PPSV23 and PCV13 are:

• Serotype coverage: PPSV23 protects against 23 serotypes, while PCV13 covers 13 serotypes
• Vaccine type: PPSV23 is a polysaccharide vaccine, while PCV13 is a conjugate vaccine
• Age recommendations: PCV13 is routinely recommended for all children under 2 and certain high-risk adults, while PPSV23 is recommended for adults 65 and older and certain at-risk individuals

When are both vaccines needed?

In some cases, particularly for individuals at high risk of pneumococcal disease, both PPSV23 and PCV13 may be recommended. Your healthcare provider can determine the most appropriate vaccination schedule based on your age, health status, and risk factors.

Pneumococcal Vaccination: A Public Health Success Story

The introduction and widespread use of pneumococcal vaccines, including PPSV23, have had a significant impact on public health. Let’s explore some of the key achievements:

Reduction in disease burden

Since the introduction of pneumococcal vaccines, there has been a marked decrease in the incidence of invasive pneumococcal disease across all age groups. This reduction has been particularly pronounced in young children and older adults, who are most vulnerable to these infections.

Herd immunity effects

Widespread vaccination has not only protected individuals who receive the vaccine but has also contributed to herd immunity. This means that even unvaccinated individuals benefit from reduced circulation of pneumococcal bacteria in the community.

Economic impact

By preventing pneumococcal infections, these vaccines have led to significant healthcare cost savings. Reduced hospitalizations, fewer antibiotic prescriptions, and fewer long-term complications have all contributed to these economic benefits.

The Future of Pneumococcal Vaccination

As our understanding of pneumococcal disease and vaccine technology continues to evolve, so too does the landscape of pneumococcal vaccination. Here are some developments to watch:

New vaccine formulations

Researchers are working on developing new pneumococcal vaccines that offer broader coverage against more serotypes. These next-generation vaccines aim to provide even greater protection against pneumococcal disease.

Improved vaccination strategies

Ongoing research is focused on optimizing vaccination schedules and identifying new at-risk populations who may benefit from pneumococcal vaccination. This could lead to updated recommendations in the future.

Combating antibiotic resistance

As antibiotic resistance becomes an increasingly pressing concern, pneumococcal vaccines play a crucial role in reducing the need for antibiotic use and slowing the development of resistant strains.

In conclusion, PPSV23 remains a cornerstone in the prevention of pneumococcal disease. Its ability to protect against 23 serotypes of pneumococcal bacteria makes it a crucial tool in public health efforts to reduce the burden of these potentially serious infections. While it’s not a perfect solution, when used in conjunction with other preventive measures and as part of a comprehensive vaccination strategy, PPSV23 plays a vital role in protecting individuals and communities from the threats posed by pneumococcal disease.

As we look to the future, ongoing research and development in the field of pneumococcal vaccination promise to bring even more effective tools to combat these infections. However, the current success of PPSV23 and other pneumococcal vaccines underscores the importance of adhering to recommended vaccination schedules and staying informed about your personal risk factors for pneumococcal disease.

Remember, vaccination is not just about protecting yourself; it’s about contributing to the health and well-being of your entire community. By choosing to get vaccinated with PPSV23 when recommended, you’re taking an important step in safeguarding your health and the health of those around you. As always, consult with your healthcare provider to determine the most appropriate pneumococcal vaccination strategy for your individual needs and circumstances.

Pneumococcal Polysaccharide Vaccine Information Statement

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Current Edition Date: 10/30/2019

• Print VIS [2 pages]
• RTF file [3 pages]
  (For use in electronic systems)

• VIS in other languages
• More information about pneumococcal vaccination

• Why get vaccinated?
• PPSV23
• Talk with your health care provider
• Risks of a vaccine reaction
• What if there is a serious problem?
• How can I learn more?

Pneumococcal polysaccharide vaccine (PPSV23) can prevent pneumococcal disease.

Pneumococcal disease refers to any illness caused by pneumococcal bacteria. These bacteria can cause many types of illnesses, including pneumonia, which is an infection of the lungs.  Pneumococcal bacteria are one of the most common causes of pneumonia.

Besides pneumonia, pneumococcal bacteria can also cause:

• Ear infections
• Sinus infections
• Meningitis (infection of the tissue covering the brain and spinal cord)
• Bacteremia (bloodstream infection)

Anyone can get pneumococcal disease, but children under 2 years of age, people with certain medical conditions, adults 65 years or older, and cigarette smokers are at the highest risk.

Most pneumococcal infections are mild. However, some can result in long-term problems, such as brain damage or hearing loss. Meningitis, bacteremia, and pneumonia caused by pneumococcal disease can be fatal.

PPSV23 protects against 23 types of bacteria that cause pneumococcal disease.

PPSV23 is recommended for:

• All adults 65 years or older,
• Anyone 2 years or older with certain medical conditions that can lead to an increased risk for pneumococcal disease.

Most people need only one dose of PPSV23. A second dose of PPSV23, and another type of pneumococcal vaccine called PCV13, are recommended for certain high-risk groups.  Your health care provider can give you more information.

People 65 years or older should get a dose of PPSV23 even if they have already gotten one or more doses of the vaccine before they turned 65.

Tell your vaccine provider if the person getting the vaccine:

• Has had an allergic reaction after a previous dose of PPSV23, or has any severe, life-threatening allergies.

In some cases, your health care provider may decide to postpone PPSV23 vaccination to a future visit.

People with minor illnesses, such as a cold, may be vaccinated. People who are moderately or severely ill should usually wait until they recover before getting PPSV23.

Your health care provider can give you more information.

• Redness or pain where the shot is given, feeling tired, fever, or muscle aches can happen after PPSV23.

People sometimes faint after medical procedures, including vaccination. Tell your provider if you feel dizzy or have vision changes or ringing in the ears.

As with any medicine, there is a very remote chance of a vaccine causing a severe allergic reaction, other serious injury, or death.

An allergic reaction could occur after the vaccinated person leaves the clinic. If you see signs of a severe allergic reaction (hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, or weakness), call 9-1-1 and get the person to the nearest hospital.

For other signs that concern you, call your health care provider.

Adverse reactions should be reported to the Vaccine Adverse Event Reporting System (VAERS). Your health care provider will usually file this report, or you can do it yourself. Visit the VAERS website or call 1-800-822-7967.  VAERS is only for reporting reactions, and VAERS staff do not give medical advice.

• Ask your health care provider.
• Call your local or state health department.
• Contact the Centers for Disease Control and Prevention (CDC):
  • Call 1-800-232-4636 (1-800-CDC-INFO) or
  • Visit CDC’s vaccine website

Many Vaccine Information Statements are available in español and other languages. See https://www.immunize.org/vis.

Vaccine Information Statement
PPSV (10/30/19)

Department of Health and Human Services
Centers for Disease Control and Prevention

Office Use Only

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PNEUMOVAX®23 (Pneumococcal Vaccine Polyvalent) | HCP Site

PNEUMOVAX 23 is indicated to help prevent pneumococcal disease caused by 23 serotypes

Learn More About Serotypes

PNEUMOVAX 23 will not prevent disease caused by capsular types of pneumococcus other than those contained in the vaccine.

Pharmacists: Take every opportunity to speak with appropriate adult patients about pneumococcal vaccination

Find Resources

ref1

Reference

1. Centers for Disease Control and Prevention (CDC). Bact facts interactive beta v8.2. Updated October 13, 2022. Accessed March 6, 2023. https://www.cdc.gov/abcs/bact-facts-interactive-dashboard.html

ref2

Reference

2. Centers for Disease Control and Prevention (CDC). Vaccine storage and handling toolkit. Published January 2023. Accessed February 13, 2023. https://www.cdc.gov/vaccines/hcp/admin/storage/toolkit/storage-handling-toolkit.pdf

ref3

Reference

3. Butler JC, Breiman RF, Campbell JF, et al. Pneumococcal polysaccharide vaccine efficacy: An evaluation of current recommendations. JAMA. 1993;270(15):1826–1831.

Indication for PNEUMOVAX 23

PNEUMOVAX^®23 (Pneumococcal Vaccine Polyvalent) is a vaccine indicated for active immunization for the prevention of pneumococcal disease caused by the 23 serotypes contained in the vaccine (1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F, and 33F).

PNEUMOVAX 23 is approved for use in persons 50 years of age or older and persons aged ≥2 years who are at increased risk for pneumococcal disease.

PNEUMOVAX 23 will not prevent disease caused by capsular types of pneumococcus other than those contained in the vaccine.

Select Safety Information for PNEUMOVAX 23

Do not administer PNEUMOVAX^®23 (Pneumococcal Vaccine Polyvalent) to individuals with a history of a hypersensitivity reaction to any component of the vaccine.

Defer vaccination with PNEUMOVAX 23 in persons with moderate or severe acute illness.

Use caution and appropriate care in administering PNEUMOVAX 23 to individuals with severely compromised cardiovascular and/or pulmonary function in whom a systemic reaction would pose a significant risk.

Available human data from clinical trials of PNEUMOVAX 23 in pregnancy have not established the presence or absence of a vaccine-associated risk.

Since elderly individuals may not tolerate medical interventions as well as younger individuals, a higher frequency and/or a greater severity of reactions in some older individuals cannot be ruled out.

Persons who are immunocompromised, including persons receiving immunosuppressive therapy, may have a diminished immune response to PNEUMOVAX 23.

PNEUMOVAX 23 may not be effective in preventing pneumococcal meningitis in patients who have chronic cerebrospinal fluid (CSF) leakage resulting from congenital lesions, skull fractures, or neurosurgical procedures.

The most common adverse reactions, reported in >10% of subjects vaccinated with PNEUMOVAX 23 for the first time in a clinical trial, were: injection-site pain/soreness/tenderness, injection-site swelling/induration, headache, injection-site erythema, asthenia and fatigue, and myalgia.

For subjects aged 65 years or older in a clinical study, systemic adverse reactions which were determined by the investigator to be vaccine-related were higher following revaccination than following initial vaccination.

Vaccination with PNEUMOVAX 23 may not offer 100% protection from pneumococcal infection.

Before administering PNEUMOVAX 23, please read the accompanying Prescribing Information. The  Patient Information also is available.

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Prices for vaccination Pnevmovax 23 (vaccination against pneumococcal infection) for children and adults in DC INVITRO, get vaccinated in Moscow and the region

Description

Pneumovax 23 (Merck Sharp&Dohme, USA) is a polyvalent polysaccharide vaccine for the prevention of pneumococcal infections over the age of 2 years.

Pneumococcal disease is one of the leading causes of death worldwide and a major cause of pneumonia, bacteremia, meningitis and otitis media.

Pneumovax 23 contains highly purified capsular polysaccharides from 23 of the most common and invasive Streptococcus pneumoniae serotypes: 1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14 , 15B, 17F, 18C, 19A, 19F, 20, 22F, 23F, 33F

Purified pneumococcal capsular polysaccharides induce antibodies that effectively protect against pneumococcal infection. Protective levels of antibodies to pneumococcal type-specific capsular antigens usually appear by the third week after vaccination. After the introduction of pneumococcal vaccine, the levels of specific antibodies decrease after 5-10 years. In some groups of people, the decrease in antibody levels may occur more quickly.

*The procedure is carried out strictly according to indications and in the presence of a referral (permission) from a doctor with the current date!

In the absence of a referral (admission) for vaccination, it is necessary to undergo an examination before vaccination by a doctor of the Medical Center (the service is paid additionally according to the Price List of the Medical Center)!

Readings

The vaccine Pneumovax 23 is intended for the prevention of pneumococcal infection (the vaccine contains a purified polysaccharide of 23 serotypes of Streptococcus pneumoniae).

Pneumococcal infection is one of the main causes of pneumonia, bacteremia, meningitis and otitis media.

Vaccination

• Routine vaccination is given at age 50 and over.
• Individuals at risk are vaccinated at 2 years of age and older.

Groups at increased risk of developing pneumococcal infections include:

• Patients with chronic cardiovascular disease (including congestive heart failure and cardiomyopathy), chronic lung disease (including chronic obstructive pulmonary disease and emphysema), or diabetes mellitus.
• Those suffering from alcoholism, chronic liver disease (including cirrhosis of the liver), or cerebrospinal fluid leakage.
• Patients with functional or anatomical asplenia (including sickle cell anemia and splenectomy).
• Persons living in special environmental conditions or special social conditions (including the peoples of the Far North).
• Patients with HIV infection, leukemia, lymphoma, Hodgkin’s disease, multiple myeloma, advanced malignancy, chronic renal failure or nephrotic syndrome, patients receiving immunosuppressive chemotherapy (including corticosteroids), and recipients after a bone marrow transplant or organ transplant.

Revaccination

• Revaccination of immunocompetent individuals is generally not recommended.
• A single booster dose is recommended for everyone aged 65 years and over 5 years after vaccination if the first vaccination was given before the age of 65 years.
• A single revaccination no earlier than 5 years after vaccination is recommended for patients who are most at risk for serious pneumococcal infections. In children under 10 years of age, if indicated, revaccination can be carried out 3 years after vaccination.
• Revaccination with Pneumovax 23 is recommended for people at risk aged 2 years and older who were vaccinated with pneumococcal conjugate vaccine more than 8 weeks ago.

Restrictions

• Hypersensitivity to any component of the vaccine.
• Severe reaction or post-vaccination complication to previous administration.
• Acute infectious and non-infectious diseases, exacerbation of chronic diseases are temporary contraindications for vaccination.
• For non-severe acute respiratory viral infections, acute intestinal diseases and other diseases accompanied by fever, vaccination is carried out immediately after the temperature returns to normal.

Sign up for a pneumococcal vaccine in Moscow / MediArt Clinic Network

Vaccination against pneumococci

Pneumococci are one of the main causative agents of meningitis, otitis media, sinusitis, community-acquired pneumonia in children and adults. In more rare cases, pneumococcus can cause infections of other localization (endocarditis, septic arthritis, primary peritonitis, cellulitis, etc.).

Pneumococcal disease is one of the leading causes of death worldwide and one of the leading causes of pneumonia, bacteremia, meningitis and otitis media.

Pneumococcal infection is usually a complication of other infections – an example of this is pneumococcal pneumonia after influenza or measles, inflammation of the middle ear (otitis media) in children, after or against the background of any respiratory viral infection.

In Russia, pneumococci cause 90% of pneumonia in children under 5 years of age . In addition, about 40% of acute otitis media in children occurs due to pneumococcus. Such otitis is characterized by great severity, a tendency to damage the eardrum and the development of complications.

Pneumococcus is the most common bacterial infection causing serious illness and death. Despite supportive treatment, mortality from pneumococcal sepsis is about 15%. In the elderly, it can reach 60%. Worldwide, pneumococcus causes up to 1.6 million deaths per year, of which about half occur in children under 5 years of age.

There are at least 91 different capsular types of pneumococci, but the majority (over 90%) of invasive diseases are caused by 23 serotypes (groups of microorganisms of the same species).

More than 35% of pneumococcal strains are reported to be resistant to penicillin in some regions. Many penicillin-resistant pneumococci are also resistant to other antimicrobials (eg, erythromycin, trimethoprim-sulfamethoxazole, and broad-spectrum cephalosporins), further highlighting the importance of pneumococcal vaccine prophylaxis.

Vaccination against pneumococcal infection is included in the national vaccination schedule of the Russian Federation.

Foreign pneumococcal vaccines are registered in Russia:

• Synflorix (Belgium) against 10 serotypes,

• Prevenar 13 (Ireland) against 13 pneumococcal serotypes,

• polysaccharide vaccine Pneumovax 23 (USA) against all 23 major serotypes of pneumococcus.

For immunization of children, conjugate vaccines are used (Prevenar-13, Synflorix).

In children over 2 years of age, adults and the elderly, the polysaccharide vaccine Pneumovax 23 is used, covering more serotypes (23).

Vaccination is effective both in organized groups (kindergartens, schools) and for children at risk. Thus, the incidence of respiratory diseases in frequently ill children after vaccination with a 23-valent pneumococcal vaccine is reduced according to some studies from 6. 54 to 0.67 cases per year per 1 child.

In bronchial asthma in children, vaccination with a 23-valent pneumococcal vaccine reduces the frequency of exacerbations of the underlying disease and the addition of respiratory infections in 60% of children.

Which children are recommended to be vaccinated against pneumococcus?

• Children with chronic lung diseases (obstructive pulmonary disease, emphysema, bronchiectasis, etc.) and bronchial asthma

• People with chronic diseases of the cardiovascular system

• Children with neurological diseases (cerebrovascular accidents, convulsive disorders, decreased cough reflex)

• Children with diabetes

• All immunocompromised children (with anatomical or functional asplenia, primary immunodeficiencies, etc.)

• Children attending children’s organized groups (often ill children in kindergartens and schools)

Vaccination is optional for adults. Vaccination is recommended for people who are at increased risk of infection, as well as for those whose diseases caused by pneumococcus are most severe and cause complications:

• adults over 50;

• people who often come into contact with possible carriers of the infection;

• employees of preschool, school institutions, boarding schools;

• those who have chronic diseases of the respiratory system, liver, diabetes mellitus;

• people suffering from immunodeficiencies;

• patients with nephrotic syndrome and renal failure;

• people with neurological diseases (cerebrovascular accidents, dementia, convulsive disorders, decreased cough reflex)

• patients who have an increased risk of meningitis (after traumatic brain injury, neurosurgical interventions on the spine).

Q&A

1. What is the interval between pneumococcal conjugate vaccine and Pneumovax 23?

The interval between administration of a pneumococcal conjugate vaccine (Prevenar 13 or Synflorix) and administration of Pneumovax 23 is at least 8 weeks.

2. What vaccines can Pneumovax 23 be combined with?

Can be administered on the same day (simultaneously) with other vaccines (except tuberculosis vaccination) in different parts of the body using different syringes.

3. What reaction after vaccination is considered normal?

Normal vaccine reactions, which may occur in about a small percentage of children, include:

• temperature increase
• local manifestations (redness, swelling, puffiness)
• mood changes (moodyness, tearfulness)
• loss of appetite.

4. Is it permissible to have more than one vaccination on the same day?

The national vaccination calendar is planned so that almost every visit to the clinic, the child receives several vaccinations. The use of complex vaccines reduces the number of injections and stress from vaccinations.

At the same time, the level of “antigenic load” from several vaccines in one day is approximately equal to the level of a regular SARS. Immunity easily copes with such a load.

5. Does the vaccinated pose a danger to others?

Most vaccines are non-live, and the vaccinated person does not affect others in any way.

Some vaccines contain live attenuated pathogens that the vaccinated can release into the environment. These weakened pathogens (viruses) are not dangerous for the vast majority, but in some situations care should be taken.

The greatest number of restrictions exist for the live oral polio vaccine (OPV), as the vaccinated person releases the vaccine virus into the environment within 60 days.

6. Why not vaccinate at home?

This is prohibited by law. In the guidelines “The procedure for conducting preventive vaccinations” is unequivocally written.