Pneumococcus, Purified Polysaccharide Antigen (PPSV)

Registered South African indications:

• Prevention of pneumococcal disease

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients

Cautions

• Pregnancy
• Breastfeeding
• Elderly
• Febrile illness
• Acute infection
• Immunocompromised patients
• Basilar skull fracture
• Cerebrospinal fluid leaks

Forms avail. in SA and covered in this monograph: inj

Primary vaccination for prevention of pneumococcal disease in patients at increased risk of morbidity and mortality from pneumococcal disease

• IM/SC: 0.5ml, as a single dose

Booster vaccination for prevention of pneumococcal disease in patients at increased risk of morbidity and mortality from pneumococcal disease

• IM/SC: 0.5ml, every 5 years

Healthy adults should not be revaccinated routinely

Revaccination recommended in the following populations: functional or anatomic asplenia, chronic renal failure or nephrotic syndrome and immunocompromised patients

See additional prescribing points for additional recommendations

23-valent pneumococcal polyscaccharide vaccine (PPSV-23) revaccination dose must be given ≥ 5 years after first dose of PPSV-23 and ≥ 8 weeks after 13-valent pneumococcal conjugate vaccine (PCV-13)

If PPSV-23 is given before PCV-13 vaccine, the minimum interval is 1 year

DO NOT administer intravascularly

Paed. forms avail. in SA and covered in this monograph: inj

Primary vaccination for prevention of pneumococcal disease in patients at increased risk of morbidity and mortality from pneumococcal disease 

Younger than 2 years

• Not established for use 

Older than 2 years

• See adult dosage

Immunization with pneumococcal conjugate vaccine (PCV-13) should be completed prior to 23-valent pneumococcal polyscaccharide vaccine (PPSV-23) as recommended

The minimum interval between PCV-13 and PPSV-23 is 8 weeks

Booster vaccination for prevention of pneumococcal disease in patients at increased risk of morbidity and mortality from pneumococcal disease

Younger than 2 years

• Not established for use

Between 2-10 years

• IM/SC: 0.5ml, every 5 years

Older than 10 years

• See adult dosage

Healthy children should not be revaccinated routinely

Revaccination recommended in the following populations: functional or anatomic asplenia, chronic renal failure or nephrotic syndrome and immunocompromised patients

DO NOT administer intravascularly

Pregnancy

• Caution
• Animal studies are insufficient with respect to effects on reproductive toxicity. The vaccine should not be used during pregnancy unless clearly necessary (the potential benefit must justify any potential risk to the fetus)
• Consider vaccination of pregnant women at high risk for infection

Breastfeeding

• Caution
• It is unknown whether this vaccine is excreted in human milk. Caution should be exercised when it is administered to a nursing mother
• Safety of breastfeeding for the mother or the infant is not affected by administration

Renal impairment

• No dose adjustment recommended

Hepatic impairment

• No dose adjustment recommended

Elderly

• Caution; no dose adjustment recommended 

Porphyria Information

• Probably not porphyrinogenic (PNP)

Drugs in Sport

• Permitted - No warning

Central Nervous System Disorders

• Febrile convulsions
• Guillain-Barré Syndrome
• Headache
• Paraesthesia
• Radiculoneuropathy

Gastrointestinal Disorders

• Nausea and vomiting

Musculoskeletal Disorders

• Arthralgia
• Arthritis
• Myalgia

Skin and Subcutaneous Tissue Disorders

• Rash
• Urticaria
• Injection site reactions

Immune, Blood and Lymphatic System Disorders

• Hemolytic anaemia
• Leukocytosis
• Lymphadenitis
• Lymphadenopathy
• Thrombocytopenia
• Anaphylactoid reactions
• Angioneurotic oedema
• Serum sickness
• Fever

Zoster Vaccine  

None routine

Additional recommendations

• It is recommended that adults 65 years of age or older receive both the 13-valent pneumococcal conjugate vaccine (PCV-13) and the 23-valent pneumococcal polyscaccharide vaccine (PPSV-23)
• The two vaccines should be given 6 months to a year apart
• The PCV-13 vaccine is usually given first followed by the PPSV-23 vaccine, except where these adults have already received the PPSV-23 vaccine already; in these instances, vaccination against pneumococcal infection is completed if PCV-13 is administered 6-12 months after PPSV-23 was given

Pneumococcal polysaccharide polyvalent is an inactive bacterial vaccine that induces active immunization to the serotypes contained in the vaccine.

Injection (per 0.5ml) 0.025mg

• Imovax pneumo 23 (Sanofi) originator (Discontinued: 13/07/2018)
• Pneumovax 23 (MSD) originator