Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Intervals between Pneumococcal Vaccines

ACIP offers immunization practice recommendations

Publish date:: September 15, 2015

The Advisory Committee on Immunization Practices (ACIP) has changed the recommended interval between 13-valent pneumococcal conjugate vaccine (PCV13) followed by the 23-valent pneumococcal polysaccharide vaccine (PPSV23) from 6 to 12 months to ≥1 year for immunocompetent adults aged ≥65 years. Recommended intervals for all other age and risk groups remain unchanged. Studies of PCV-PPSV23 sequence among immunocompetent adults suggest that:

• Shorter intervals may be associated with increased local reactogenicity when compared with longer intervals.

• Longer intervals may lead to an improved immune response against serotypes in both vaccines compared with a single dose of PCV13 or PPSV23.

ACIP currently recommends that a dose of PCV13 be followed by a dose of PPSV23 in all adults aged ≥65 years who have not previously received pneumococcal vaccine and in persons aged ≥2 years at high risk for pneumococcal disease because of underlying medical conditions.

Citation: Kobayashi M, Bennett NM, Gierke R, et al. Intervals between PCV13 and PPSV23 vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 2015;64(34):944-947.

Commentary: The reasons behind this recommendation are interesting and now make the recommended interval consistent with what most clinicians are currently doing. This is the interval that is required for payment of both vaccines by Medicare. Since about 85% of adults in the US aged ≥65 years have seen a clinician in the past 6 months, and over 93% within the preceding year, the recommendation is also easy to implement without requiring additional visits.¹ —Neil Skolnik, MD

1. Blackwell DL, Lucas JW, Clarke TC. Summary health statistics for US adults: national health interview survey, 2012. Vital Health Stat 10. 2014;10:1–161.

This Week's Must Reads

Consider potential cognitive complications prior to androgen deprivation therapy,

Diabetes raises risk of prostate cancer mortality in obese men,

Salivation inhibition fails to reduce radioiodine toxicity in prostate cancer,

Highest positive surgical margin predicts poor survival after prostatectomy,

Young minority men are underinformed about prostate cancer screening,

Must Reads in Infectious Diseases

Rapid Point of Care Test for Influenza, J Am Board Fam Med; 2019 Mar; Dale, et al

Invasive GBS Infections in Nonpregnant US Adults, JAMA Intern Med; ePub 2019 Feb 18; Francois Watkins, et al

Prescribed Opioids & Risk of CAP in Patients with HIV, JAMA Intern Med; 2019 Jan 7; Edelman, et al

Influenza Vaccination Safety During Hospitalization, Mayo Clin Proc; ePub 2019 Jan 8; Tartof, et al

Hospitalization Trends for Drug-Use Associated IE, Ann Intern Med; ePub 2018 Dec 4; Schranz, et al