Identify Patients Who Should Be Offered a Pneumococcal Vaccine

We’re getting questions about differences between the two pneumococcal vaccines...Prevnar 13 and Pneumovax 23.

Are the two pneumococcal vaccines interchangeable? No.

Both vaccines protect against infections caused by Streptococcus pneumoniae...which is a leading cause of bacteremia, meningitis, and pneumonia.

But Prevnar 13 has 13 different strains of S. pneumo...including one strain not in Pneumovax 23. Pneumovax 23 has 23 strains...covering 11 strains that aren’t in Prevnar 13.

Which patients should get which pneumococcal vaccine? Patients 65 years and older should receive BOTH vaccines, usually given at least one year apart. Younger, immunosuppressed patients should also get both, but they may only be separated by 8 weeks.

But only offer Pneumovax 23 to patients under 65 years if they have conditions such as diabetes, COPD, or heart failure.

Focus on identifying high-risk patients who haven’t received either vaccine.

If ordered, feel comfortable administering either pneumococcal vaccine to most hospitalized patients. In fact, some states still require hospitals to offer a pneumococcal vaccine to eligible patients...even though it’s no longer a quality measure for The Joint Commission or Medicare.

Will hospitals carry both pneumococcal vaccines? Probably, so watch for mix-ups.

Bar-code scan before administration...and verify you provide the patient with the correct Vaccine Information Statement.

Give Prevnar 13 as an IM injection...and shake right before administration to mix the white suspension.

But Pneumovax 23 can be given IM or subcutaneously...and is a clear liquid that does not need to be shaken.

See our chart, Pneumococcal Vaccination in Adults, for more on identifying patients...and vaccine administration, side effects, etc.

Key References
Nurse’s Letter. Aug 2018, No. 340834

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