Health Advisory
2009-2010 Influenza Season Update #11

Pneumococcal Vaccination Recommended
to Help Prevent Secondary Infections

To: Vermont Health Care Providers
From: Wendy Davis, MD, Commissioner
Date: November 19, 2009

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Streptococcus pneumoniae (pneumococcus) remains a leading cause of vaccine-preventable illness and death in the U.S. Influenza predisposes a person to develop bacterial community-acquired pneumonia. Recently, pneumococcal infections have been identified as an important complication in severe and fatal cases of 2009 H1N1 influenza virus infection. A key difference between this pandemic and those of the past is that now we have two pneumococcal vaccines that may help to prevent these infections.  

Recommendations

CDC’s Advisory Committee on Immunization Practices (ACIP) recommends a single dose of 23-valent pneumococcal polysaccharide vaccine (PPSV) for all people age 65 and older and for people age 2 through 64 who have certain high-risk conditions:

ACIP Recommendations for Use of Pneumococcal Polysaccharide Vaccine: http://www.cdc.gov/h1n1flu/vaccination/provider/provider_pneumococcal.htm#table1

Special emphasis should be given to vaccinating adults under age 65 who have established high-risk conditions for pneumococcal disease. PPSV coverage among this group is low, and this group may be more likely to develop secondary bacterial pneumonia after an influenza infection. All children younger than age 5 should continue to receive the 7-valent  pneumococcal conjugate vaccine (PCV7) according to existing recommendations. A single pneumococcal revaccination at least five years after initial vaccination is recommended for people 65 years and older who were first vaccinated before age 65, and for people at highest risk of disease – such as those who have functional and anatomical asplenia, HIV infection, AIDS or malignancy and have at least five years elapsed from receipt of first vaccination. Use of PPSV among people without current indications for vaccination is not recommended at this time.

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