Pneumococcal Vaccination Algorithm for Adults
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yes
no
<-- Has the patient previously received PPSV23 (Pneumovax 23)?
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yes
no
<-- Is the patient at least 65 years of age?
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yes
no
<-- Does the patient have a PCV13 (Prevnar 13) qualifying condition?
High-risk patients in whom PCV13 is preferred include those with cochlear implants, chronic renal failure, congenital or acquired asplenia, congenital or acquired immunodeficiency, cerebrospinal fluid leak, generalized malignancy, human immunodeficiency virus infection, Hodgkin disease, leukemia, lymphoma, multiple myeloma, nephrotic syndrome, sickle cell disease, and solid organ transplant; and those receiving long-term corticosteroids or radiation therapy.
RECOMMENDATION --> Administer PCV13, then PPSV23 at least eight weeks later (one year later for patients covered by Medicare Part B)
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yes
no
<-- Does the patient have a PPSV23 qualifying condition?
Patients with chronic illness in whom PPSV23 is preferred include those who smoke and those with alcoholism; diabetes mellitus or chronic heart, liver, or lung disease.
RECOMMENDATION --> No Vaccine Required.
RECOMMENDATION --> Administer PPSV23. Wait at least one year to give PCV13 if patient subsequently turns 65 years of age or develops a qualifying condition.
RECOMMENDATION --> Administer PCV13, then PPSV23 at least eight weeks later (one year later for patients covered by Medicare Part B)
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yes
no
<-- Was it administered more than one year ago?
RECOMMENDATION --> Wait one year
-choose-
yes
no
<-- Does the patient have a PCV13 (Prevnar 13) qualifying condition?
High-risk patients in whom PCV13 is preferred include those with cochlear implants, chronic renal failure, congenital or acquired asplenia, congenital or acquired immunodeficiency, cerebrospinal fluid leak, generalized malignancy, human immunodeficiency virus infection, Hodgkin disease, leukemia, lymphoma, multiple myeloma, nephrotic syndrome, sickle cell disease, and solid organ transplant; and those receiving long-term corticosteroids or radiation therapy.
-choose-
yes
no
<-- Is the patient at least 65 years of age?
RECOMMENDATION --> No Vaccine Required.
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yes
no
<-- Has it been at least five years since PPSV23 was administered if patient was younger than 65 years at the time?
RECOMMENDATION --> Administer PCV13 if it has been at least eight weeks since PPSV23 was received, repeat PPSV23 five years after prior PPSV23 dose.
RECOMMENDATION --> Administer PCV13, then PPSV23 at least eight weeks later (one year later for patients covered by Medicare Part B).
RECOMMENDATION --> Administer PCV13.
References (Hide/Show)
Centers for Disease Control and Prevention. Pneumococcal Vaccination: Summary of Who and When to Vaccinate. https://www.cdc.gov/vaccines/vpd/pneumo/hcp/who-when-to-vaccinate.html. Accessed January 8, 2017.
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