Opinion
Video
Author(s):
An expert discusses how pharmacists should follow CDC immunization schedules for different age groups and use shared clinical decision-making for patients with prior vaccination history, while considering contraindications primarily related to severe allergic reactions to vaccine components.
Video content above is prompted by the following:
CDC immunization schedules provide clear guidance for pneumococcal vaccination across age groups, with pediatric schedules utilizing PCV15 or PCV20 at 2, 4, 6, and 12 to 15 months of age. Adult recommendations include 3 primary options: PCV15 plus PPSV23, PCV20 alone, or PCV21 alone for patients 50 years and older regardless of health status. Adults aged 19 to 49 years with risk factors including chronic diseases, immunocompromising conditions, cochlear implants, or cerebrospinal fluid leaks should receive pneumococcal vaccination using any of the 3 recommended series.
For adults 50 years and older with prior pneumococcal vaccination history, shared clinical decision-making becomes essential, particularly for patients who completed the PCV13 plus PPSV23 series more than 5 years ago. The Advisory Committee on Immunization Practices (ACIP) recommends considering PCV20 or PCV21 for these patients based on individual risk assessment and patient preferences. Incomplete vaccination series require careful evaluation using detailed ACIP’s guidelines and immunization schedule footnotes to determine appropriate next steps and optimize protection.
Contraindications to pneumococcal vaccination are limited to severe allergic reactions to vaccine components or previous doses that resulted in anaphylaxis. Health care providers must carefully evaluate the nature of prior adverse reactions, distinguishing between expected local reactions (pain, swelling, redness) and serious systemic reactions requiring medical intervention. Risk-benefit discussions and supervised vaccination in medical settings may be appropriate for patients with mild previous reactions, ensuring both safety and optimal disease prevention.
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