Vaccination against pneumococcal disease caused by pneumococcal types included in the vaccine in selected individuals aged ≥2 yr w/ chronic CV disease, chronic pulmonary disease or DM; w/ alcoholism, chronic liver disease or CSF leaks; w/ functional or anatomic asplenia; living in special environments or social settings; w/ HIV infection, leukemia, lymphoma, Hodgkin's disease, multiple myeloma, generalized malignancy, chronic renal failure or nephrotic syndrome; in those receiving immunosuppressive chemotherapy; & those who have received an organ or bone marrow transplant. Routine vaccination for patients ≥50 yr.
Do not administer IV or intradermally. Patients receiving immunosuppressive therapy. Intradermal administration may cause severe local reactions. Individuals w/ severely compromised CV &/or pulmonary function. May delay use in any febrile resp illness or other active infection. Patients who require penicillin or other antibiotic prophylaxis against pneumococcal infection, such prophylaxis should not be discontinued after vaccination. May not result in complete protection in all recipients. Pneumovax 23 will not prevent disease caused by capsular types of pneumococcus other than those contained in the vaccine. May not be effective in preventing infection resulting from basilar skull fracture or from external communication w/ CSF. Avoid vaccination during chemotherapy or RT. Revaccination of immunocompetent persons previously vaccinated w/ 23-valent polysaccharide vaccine is not routinely recommended. Pregnancy & lactation. Not recommended for use in childn <2 yr; may consider revaccination 3 yr after previous dose in childn ≤10 yr at highest risk of severe pneumococcal infection. Elderly ≥65 yr.
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