Presentation on theme: "UPDATE ON PNEUMOCOCCAL VACCINES CSF showing meningitis caused by S. pneumoniae Photo Credit: Content Providers(s): CDC/Dr. M.S. Mitchell - This media comes."— Presentation transcript:
UPDATE ON PNEUMOCOCCAL VACCINES CSF showing meningitis caused by S. pneumoniae Photo Credit: Content Providers(s): CDC/Dr. M.S. Mitchell - This media comes from the Centers for Disease Control and Prevention's Public Health Image Library (PHIL), with identification number #1003Centers for Disease Control and PreventionPublic Health Image Library#1003
Objectives for Today Describe pneumococcal disease basics Identify which adults need both PCV13 and PPSV23 Indentify which adults age need just PPSV23
Pneumococcal Disease Second most common cause of vaccine preventable death in the US Major clinical syndromes include Pneumonia Bacteremia Meningitis. It is better to prevent than to try and fight pneumococcal disease with antibiotics that might not work.
Pneumococcal Pneumonia Estimated 175,000 hospitalizations in U.S. Up to 36% of adult-community acquired pneumonia and 50% of hospital acquired pneumonia Common complication (bacterial) of influenza and measles Case fatality rate 5-7%, much higher in elderly Pneumonia of the right middle lobe
Pneumococcal Bacteremia More than 50,000 cases per year in the United States Rates higher among elderly and very young infants Case-fatality rate ~20%; up to 60% among the elderly Septi Chek Blood Culture Bottles
Pneumococcal Meningitis Estimated 3,000–6,000 cases per year in the United States Case-fatality rate ~30%, up to 80% in the elderly Neurologic sequelae common among survivors Increased risk in persons with cochlear implant Photo courtesy of CDC
The following are at HIGH RISK for PNEUMOCCAL DISEASE: ●Those ≥ 65 Years of Age ●Persons years with asthma or smokes cigarettes ●Persons with chronic illnesses
Adult 65 and Older CDC recommends all adult ≥ 65 receive 2 types of pneumococcal vaccines One dose of PCV13 (first) One dose of PPSV23 ( 6 to 12 months after PCV vaccine) This age group requires both vaccines for the best protection against pneumococcal disease
Adult 19 to 64 Years Who Only Need PPSV23 Those with chronic conditions Asthma Diabetes Heart disease Alcoholism Liver disease Cigarette smokers Residents of nursing homes or other long-term care facilities When they turn 65 this group should receive a dose of PCV13
Adults 19 to 64 Who Should Receive both PCV13 and PPSV23* Functional or anatomic asplenia† Cochlear implants Cerebrospinal fluid leaks† Lymphoma, leukemia, Hodgkin disease,† Solid organ transplants† * PCV13 and PPSV23 cannot be given at the same visit † A second PPSV23 vaccine is recommended for these individuals five years after the first PPSV23 dose
Age 65 Years or Older
Age Years with Underlying Conditions
The Centers for Medicare and Medicaid Services Update CMS is updating their coverage to align with the new ACIP Pneumococcal Vaccine guidelines An initial pneumococcal vaccine to who have never received the vaccine under Part B; and A different, second pneumococcal vaccine one year after the first vaccines was administered Effective dates of service on or after September 19, 2014 and does not require that a doctor of medicine or osteopathy order the vaccines.
Scenario 1 66 year old patient with a cochlear implant. Previously received a PPSV23 at age 55. What pneumococcal vaccine (s) does this patient need?
Scenario 2 A 20 year old asthma patient shows at your clinic, asking for a shot of that” new pneumonia shot” (PCV13). Does this patient need a PCV13 or a PPSV23 today?