Version 20.6
Pneumococcal vaccine administration requires complex clinical decision making. Currently PCV13 is recommended as part of routine childhood immunization delivery per ACIP guidelines. OP's Vaccine Logic supports forecasting of PCV13 for the following.
- 4 dose series given at 2, 4, 6 and 12-15 months.
- Catch-up schedule of 1 dose for health children ages 24-59 months with any incomplete PCV13 series.
In addition, both PCV13 and PPSV23 may be indicated in certain situations. OP's Vaccine Logic does not have clinical diagnoses indicators that trigger patient-specific vaccine schedules. It is up to the treating provider to recognize when these special situations apply to a particular patient and follow the current recommendations including coordination of care with any treating specialist. Please note that OP refers to PPSV23 as PPV.
When a provider identifies the need for PPV vaccine for a particular patient the Indicators will need to be updated. Follow the below instruction to update the PPV indicator.
- Navigate to Immunizations: Clinical, Practice Management or Billing tab > Patient Chart > Immunizations.
- Click the Indicator tab.
- Click the Influenza / PPV / Synagis Indicators tab then select the PPV indicated radio button.
Note: For patients whom a single dose of additional pneumococcal vaccine may be clinically indicated (either PCV13 or PCV23) such as one in which there is laboratory evidence of suboptimal response to infant pneumococcal vaccines, this indicator should not be checked. This applies to patients with underlying conditions where you anticipate need for repeated pneumococcal vaccines per the special situation schedule. |
Special Situations for High-Risk Conditions
The special situations listed are as of 9/15/2020 adapted from the CDC Vaccine Schedules. The high-risk conditions are when both PCV13 and PPSV23 are indicated and where PCV13 has been administered first. PCV13 and PPSV23 should not be administered during the same visit. The below table is used for an incomplete series where the patient has not received all doses in either the recommended series or an age-appropriate catch-up series. See Tables 8, 9, and 11 in the ACIP pneumococcal vaccine recommendations for complete schedule details.
| Chronic Heart Disease Chronic Lung Disease Diabetes Mellitus |
| |
| Age | Series | Recommendations |
| 2-5 years | 3 PCV13 doses | 1 dose PCV13 a minimum of 8 weeks after any prior PCV13 dose. |
| Less than 3 PCV13 doses | 2 doses PCV13 8 weeks after the most recent and and administered 8 weeks apart. | |
| No history of PPSV23 | 1 dose of PPSV23 8 weeks after any prior PCV13 dose. | |
| 6-18 years | No history of PPSV23 | 1 dose of PPSV23 8 weeks after any prior PCV13 dose. |
| Cerebrospinal Fluid Leak Cochlear Implant | ||
| Age | Series | RecommendationsPCV13 |
| 2-5 years | 3 PCV13 doses | 1 dose PCV13 a minimum of 8 weeks after any prior PCV13 dose. |
| Less than 3 PCV13 doses | 2 doses PCV13 8 weeks after the most recent and and administered 8 weeks apart. | |
| No history of PPSV23 | 1 dose of PPSV23 8 weeks after any prior PCV13 dose. | |
| 6-18 years | No history of either PCV13 or PPSV23 | 1 dose of PCV13 and 1 dose PPSV23 at least 8 weeks later. |
| Any PCV13 but no PPSV23 | 1 dose of PPSV23 8 weeks after the most recent PCV13 dose. | |
| PPSV23 but no PCV13 | 1 dose of PPV13 at least 8 weeks after the most recent PPSV23 dose. | |
| Chronic renal failure Anatomic or functional asplenia Solid organ transplant HIV infection Multiple myeloma | Sickle cell disease and other hemoglobinopathies Congenital or acquired immunodeficiency Nephrotic syndrome Malignant neoplasms, Leukemias, Lymphomas, Hodgkin disease and other diseases associated with treatment with immunosuppressive drugs or radiation therapy | |
| Age | Series | RecommendationsPCV13 |
| 2-5 years | 3 PCV13 doses | 1 dose PCV13 a minimum of 8 weeks after any prior PCV13 dose. |
| Less than 3 PCV13 doses | 2 doses PCV13 8 weeks after the most recent and and administered 8 weeks apart. | |
| No history of PPSV23 | 1 dose PCV13 and 2 doses PPSV23, first dose PPSV23 8 weeks after PCV13 dose then second dose PPSV23 5 years after the first PPSV23. | |
| 6-18 years | No history of either PCV13 or PPSV23 | 1 dose PCV13 and 2 doses PPSV23, first dose PPSV23 8 weeks after PCV13 dose then second dose PPSV23 5 years after the first PPSV23. |
| Any PCV13 but no PPSV23 | 2 doses of PPSV23 first dose PPSV23 8 weeks after PCV13 dose then second dose PPSV23 5 years after the first PPSV23. | |
| PPSV23 but no PCV13 | 1 dose of PPV13 at least 8 weeks after the most recent PPSV23 dose then second dose PPSV23 5 years after the first PPSV23 and at least 8 weeks after a dose of PCV13. | |
| Chronic Liver Disease Alcoholism | ||
| Age | Series | Recommendations |
| 6-18 years | No history of PPSV23 | 1 dose of PPSV23 8 weeks after any prior PCV13 dose. |
