Indications
In the United States, PPSV is recommended for adults 65 years of age or older, adults with serious long-term health problems, smokers, children older than two years with serious long-term health problems, and even adults aged 55 years or younger, giving the protection of 5 years or more. The World Health Organization recommendations are similar. The WHO does not recommend use of PPV in routine childhood immunization programs.
In the United Kingdom, PPV is recommended (as a part of routine vaccination schedules) for those over the age of 65, as well as for both children and adults in special risk categories:
- Serious breathing problems, including Asthma and COPD
- Serious heart conditions, such as Congestive heart failure
- Severe kidney problems
- Long term liver disease
- Diabetes requiring medication
- Immunosuppression due to disease (e.g. HIV/AIDS or lupus) or treatment (e.g. chemotherapy or radio therapy, long-term steroid use, and problems with the spleen (asplenia), either because the spleen has been removed (splenectomy) or does not work properly (for example, due to sickle cell disease).
In March 2011, The Joint Committee on Vaccination and Immunisation (JCVI) advised to stop using pneumococcal polysaccharide vaccine (PPV), for those aged 65 years and older. PPV should however still be offered to those in clinical risk groups.
PPSV is important for HIV patients. In Canadian HIV patients, the vaccine has been reported to decrease the incidence of invasive pneumococcal disease from 768/100,000 person-years to 244/100,000 patient-years. Current WHO guidelines recommend immunization with PPV-23 for HIV patients in clinical stage 1, while the CDC recommends immunization in those with a CD4 cell count greater than 200/μL.
Read more about this topic: Pneumococcal Polysaccharide Vaccine
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