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Pneumococcal vaccination for children age 2 through 5 years at high risk for invasive pneumococcal disease

Pneumococcal vaccination for children age 2 through 5 years at high risk for invasive pneumococcal disease
This algorithm is intended for use with UpToDate content on pneumococcal vaccination in children. Please refer to UpToDate content on pneumococcal vaccination in children for additional details regarding vaccine administration.

CGD: chronic granulomatous disease; CSF: cerebrospinal fluid; PCV13: 13-valent pneumococcal conjugate vaccine; PCV15: 15-valent pneumococcal conjugate vaccine; PPSV23: 23-valent pneumococcal polysaccharide vaccine; IPD: invasive pneumococcal disease.

* PCV13 and PCV15 can be used interchangeably.

¶ Refer to UpToDate content on pneumococcal vaccination in children for additional information about pneumococcal immunization in high-risk children older than 6 years. Immune-compromised children at high risk for IPD should receive a second dose of PPSV23, which is usually given ≥5 years after the first. However, for children with sickle cell disease, some experts recommend an interval of 3 years between the first and second PPSV23. Refer to UpToDate content on management of sickle cell disease for details.
Based on data from:
  1. American Academy of Pediatrics. Streptococcus pneumoniae (pneumococcal) infections. In: Red Book: 2021-2024 Report of the Committee on Infectious Diseases, 32nd ed, Kimberlin DW, Barnett ED, Lynfield R, Sawyer MH (Eds), American Academy of Pediatrics, Itasca, IL 2021. p.717.
  2. Nuorti JP, Whitney CG, Centers for Disease Control and Prevention (CDC). Prevention of pneumococcal disease among infants and children–use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine–Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2010; 59:1.
  3. Rubin LG, Levin MJ, Ljungman P, et al. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis 2014; 58:e44.
  4. Kobayashi M, Farrar JL, Gierke R, et al. Use of 15-valent pneumococcal conjugate vaccine among U.S. children: Updated recommendations of the Advisory Committee on Immunization Practices - United States, 2022. MMWR Morb Mortal Wkly Rep 2022; 71:1174.
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