Pneumococcal polysaccharide unconjugated Vaccine
Indications
Pneumococcal polysaccharide unconjugated Vaccine is used for:
Prevention of pneumococcal disease
Adult Dose
Intramuscular
Active immunisation against pneumococcal disease
Adult: >65 years and 2 years-64 years of age who are at high risk of pneumococcal disease (e.g., those with sickle cell disease, HIV infection, or other immunocompromising conditions)
As 23-valent vaccine: Single dose of 0.5 ml, to be given at least 2 wk before elective splenectomy, chemotherapy or other immunosuppressive treatment.
Revaccination is not generally required except, after 5 yr, in patients who may have rapidly declining antibody concentrations e.g. those with asplenia or splenic dysfunction, or those with nephrotic syndrome.
Child Dose
Intramuscular
Active immunisation against pneumococcal disease
Child >2 years of age who are at high risk of pneumococcal disease (e.g., those with sickle cell disease, HIV infection, or other immunocompromising conditions)
As 23-valent vaccine: Single dose of 0.5 ml, to be given at least 2 wk before elective splenectomy, chemotherapy or other immunosuppressive treatment.
Revaccination is not generally required except, after 5 yr, in patients who may have rapidly declining antibody concentrations e.g. those with asplenia or splenic dysfunction, or those with nephrotic syndrome.
Renal Dose
Administration
Admin is preferably in the deltoid muscle or lateral mid-thigh. May be given via SC inj if patient has bleeding disorders.
Contra Indications
A known allergy to one of the components of the vaccine. Fever or acute disease or a relapse of a chronic disease: It is preferable to postpone vaccination. Vaccination is not recommended for subjects who have been vaccinated within the previous 3 years, unless indicated otherwise. A confirmed or suspected episode of pneumococcal infection is not a contraindication and vaccination should be considered according to the underlying risk status.
Precautions
Severe renal, hepatic, cardiac, vascular &/or pulmonary dysfunction. Patients on immunosuppressants may be unable to attain required antibody titres. Pregnancy & lactation. Efficacy may be reduced in multiple myeloma, Hodgkin's and non-Hogkin's lymphoma, especially during treatment and in chronic alcoholism. Vaccine should be given 2 wk before starting immunosuppressive treatment or at least 3 mth after treatment completion.
Pregnancy-Lactation
Pregnancy
Human data from clinical trials in pregnancy have not been established the presence or absence of a vaccine-associated risk
Developmental toxicity studies have not been conducted in animals
Lactation
Unknown if excreted in human milk
Interactions
Reduce immune response to Zostavax. Immunosuppressives.
Adverse Effects
Side effects of Pneumococcal polysaccharide unconjugated Vaccine :
Local Reactions at the Injection Site: Pain, erythema (redness), induration and oedema (swelling). These reactions are mild and transient. Rare reactions eg, Arthus phenomenon (severe local reactions) are reversible without after-effects; they mainly occur in subjects with high initial levels of pneumococcal antibody. Moderate and transient hyperthermia (fever) sometimes >39°C which generally occurs very shortly after vaccination and resolves within 24 hrs.
Other General Reactions: Adenopathy (inflammation of the lymph nodes), rashes, arthralgia (pain in the joints) and allergic reactions [urticaria, Quincke'soedema (type of urticaria with sudden swelling of the face and neck), anaphylactoid reactions (severe allergic reaction)], headache, muscle pain, malaise, and fatigue have exceptionally been reported.
Mechanism of Action
S. pneumoniae capsular antigens stimulate active immune response resulting in production of endogenously produced antibodies