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  • Pneumovax 23
    (Pneumococcal Vaccine Polyvalent) - Merck

    THERAPEUTIC CLASS

    Vaccine

    DEA CLASS

    RX

    INDICATIONS

    Active immunization for the prevention of pneumococcal disease caused by the 23 serotypes contained in the vaccine in persons ≥50 yrs of age and persons aged ≥2 yrs who are at increased risk for pneumococcal disease.

    ADULT DOSAGE

    Adults: Single 0.5mL dose SQ/IM into the deltoid muscle or lateral mid-thigh.

    PEDIATRIC DOSAGE

    Pediatrics: ≥2 Yrs: Single 0.5mL dose SQ/IM into the deltoid muscle or lateral mid-thigh.

    HOW SUPPLIED

    Inj: 0.5mL [single-dose, 5-dose vial]

    WARNINGS/PRECAUTIONS

    Do not inject intravascularly or intradermally. Defer vaccination in patients with moderate or severe acute illness. Caution with severely compromised cardiovascular (CV) and/or pulmonary function in those whom a systemic reaction would pose a significant risk. Does not replace the need for antibiotic prophylaxis (eg, penicillin) against pneumococcal infection; do not d/c use of antibiotic prophylaxis after vaccination in patients who require antibiotic prophylaxis. Response to vaccine may be diminished in immunocompromised individuals. May not prevent pneumococcal meningitis in patients with chronic CSF leakage resulting from congenital lesions, skull fractures, or neurosurgical procedures. Will not prevent disease caused by capsular types of pneumococcus other than those contained in the vaccine. Advisory Committee on Immunization Practices has recommendations for revaccination for persons at high risk who were previously vaccinated with Pneumovax 23; routine revaccination of immunocompetent patients previously vaccinated with a 23-valent vaccine is not recommended.

    ADVERSE REACTIONS

    Local inj-site reactions (eg, pain, soreness, tenderness, swelling, induration, erythema), asthenia, fatigue, myalgia, headache.

    DRUG INTERACTIONS

    Persons receiving immunosuppressive therapies may have a diminished immune response to the vaccine. Reduced immune response to zoster vaccine live with concurrent administration; separate vaccinations by at least 4 weeks.

    PREGNANCY

    Category C, caution in nursing.

    MECHANISM OF ACTION

    Vaccine; induces antibodies that enhance opsonization, phagocytosis, and killing of pneumococci by leukocytes and other phagocytic cells.

    ASSESSMENT

    Assess for history of hypersensitivity to any component of the vaccine, health/immune status, vaccination history, compromised CV/pulmonary function, chronic CSF leakage, moderate or severe acute illness, pregnancy/nursing status, and possible drug interactions.

    MONITORING

    Monitor patients with compromised CV and/or pulmonary function. Monitor for hypersensitivity reactions and for other possible adverse reactions.

    PATIENT COUNSELING

    Inform of potential benefits/risks of vaccination. Inform that the vaccine may not offer 100% protection from pneumococcal infection. With each immunization, provide the patient or parent/guardian with the vaccine information statements required by the National Childhood Vaccine Injury Act of 1986. Instruct to inform physician of any adverse reactions.

    ADMINISTRATION/STORAGE

    Administration: IM or SQ route. Inject into the deltoid muscle or lateral mid-thigh. Do not mix with other vaccines in the same syringe or vial. Storage: 2-8°C (36-46°F).