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PPSV23: Pneumococcal Vaccine Forecasting in OP

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.

  1. Navigate to Immunizations: Clinical, Practice Management or Billing tab > Patient Chart > Immunizations.
  2. Click the Indicator tab.
  3. 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
  • Chronic heart disease, particularly cyanotic congenital heart disease and cardiac failure.
  • Chronic lung disease, including asthma treated with high-dose oral corticosteroids.
AgeSeriesRecommendations
2-5 years3  PCV13 doses1 dose PCV13 a minimum of 8 weeks after any prior PCV13 dose.
Less than 3 PCV13 doses2 doses PCV13  8 weeks after the most recent and and administered 8 weeks apart.
No history of PPSV231 dose of PPSV23 8 weeks after any prior PCV13 dose.
6-18 yearsNo history of PPSV231 dose of PPSV23 8 weeks after any prior PCV13 dose.
Cerebrospinal Fluid Leak
Cochlear Implant


AgeSeriesRecommendationsPCV13  
2-5 years3  PCV13 doses1 dose PCV13 a minimum of 8 weeks after any prior PCV13 dose.
Less than 3 PCV13 doses2 doses PCV13  8 weeks after the most recent and and administered 8 weeks apart.
No history of PPSV231 dose of PPSV23 8 weeks after any prior PCV13 dose.
6-18 yearsNo history of either PCV13 or PPSV231 dose of PCV13 and 1 dose PPSV23 at least 8 weeks later.
Any PCV13 but no PPSV231 dose of PPSV23 8 weeks after the most recent PCV13 dose.
PPSV23 but no PCV131 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

AgeSeriesRecommendationsPCV13  
2-5 years3  PCV13 doses1 dose PCV13 a minimum of 8 weeks after any prior PCV13 dose.
Less than 3 PCV13 doses2 doses PCV13  8 weeks after the most recent and and administered 8 weeks apart.
No history of PPSV231 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 yearsNo history of either PCV13 or PPSV231 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 PPSV232 doses of PPSV23  first dose PPSV23 8 weeks after PCV13 dose then second dose PPSV23 5 years after the first PPSV23.
PPSV23 but no PCV131 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


AgeSeriesRecommendations
6-18 yearsNo history of PPSV231 dose of PPSV23 8 weeks after any prior PCV13 dose.