Pneumovax 23: Pneumococcal polysaccharide vaccine

Pneumovax 23: 23 valent pneumococcal polysaccharide vaccinePneumovax 23 is 23 valent pneumococcal polysaccharide vaccine. It is used to prevent the diseases caused by Streptococcus pneumoniae strains. It gives immunity against Streptococcus pneumoniae serotypes 1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F, and 33F. These all antigens are polysaccharide in nature. Being polysaccharide they are not very effective in inducing immunity in children less than 2 years of age. In those above 2 years of age they cannot induce long term memory in immunity. 

Pneumovax 23 vaccine 

Pneumovax 23 vaccine is available in injection form. It is ready to inject liquid. It is available in syringe and a vial. Generally sterile needle for IM injection is provided with it.

How Pneumovax 23 vaccine is given?

Pneumovax 23 vaccine is given by injection. It is generally given on anterolateral aspect of thigh in children and deltoid muscles in adult. It is given intramuscular or subcutaneous. Safety injection precautions should be followed while giving injection. This injection should not be given intravenous, or intradermal as safety and immunogenicity of such route is not known.

How does Pneumovax 23 vaccine work?

Pneumovax 23 vaccine is method of active immunization. When this injection is given to the infant or child, the serotype antigens in it get recognized by the immune system. Immune system forms antibodies against it. Immune system also forms the memory immunity against all these antigens but this memory may not effectively formed against antigen that are polysaccharide in nature, so when actual infection with same serotypes occur the immune mechanism fastly ramps up the fight and the infection is brought under very effectively and also the disease stage of infection is prevented. As body learns to fight infection even the commensal infection by above serotype bacteria is fought back. It also changes the carrier pattern of these serotypes in normal population. Thus to some extent even the contacts are protected if sufficiently large population is vaccinated with this vaccine. Booster dose is used to boost the immune response and it also helps to confer the prolonged immunity.

Which diseases are prevented by Pneumovax 23 vaccine?

The diseases caused by the serotypes of Streptococcus pneumoniae contained in vaccine are prevented. These include pneumonia, otitis media, meningitis, Some streptococcal skin infections. 

How Pneumovax 23 vaccine is stored?

Pneumovax 23 vaccine  is needed to be stored in the temperature range 2-8 degree Celsius and cold chain should be maintained during transport and storage till injection is administered. Accidentally frozen doses should not be used and discarded. The vaccine which has passed expiry should be discarded. While discarding standard biomedical waste management guidelines should be followed to prevent damage to environment.

At what age this Pneumovax 23 vaccine is given?

Pneumococcal Pneumovax 23 vaccine is given above 2 years in children if children has high risk of getting pneumococcal disease.Pneumovax vaccine is indicated in age above 50 years for all adults.Those who have high risk of getting infection should get repeated doses of Pneumovax 23 vaccine.

What if someone has missed the dose?

If someone has missed dose of this vaccine it should be given as earliest as possible.

Safety of Pneumovax 23 vaccine

Interference in producing effective response was observed in some studies when Pneumovax 23 was given with Zostavax vaccine. No such reaction was observed when 4 weeks gap was there between these two doses.Zostavax is no longer marketed available in USA.

What are side effects of This vaccine?

  • Very common side effects are fever, local pain and swelling, irritability, loss of appetite, diarrhea, headache, loss of sleep, restlessness.
  • These all side effects are usually mild and can be managed at home with or without medications.
  • Fever can be moderate to high grade after vaccination and subsides with oral paracetamol and sponging.
  • Local pain and swelling can be managed with paracetamol and local cold fomentation as needed.
  • Loss of appetite and irritability usually subsides buy its own after some hours.
  • For diarrhea frequency of breast feeding is increased and oral rehydrating solution can be given.
  • Headache may subside by its own or may need oral paracetamol.
  • Though side effects may occur they are usually for short period and milder than diseases that are prevented by the vaccine.
  • Like all other vaccine this vaccine may induce severe anaphylactic reaction which may be life threatening. Such reactions are extremely rare but occur with real possibility. The facility at which vaccine is given should be ready with skill and medicines and equipment to manage anaphylaxis.

To whom this vaccine should not be given?

There are few contraindications to Pneumovax 23 vaccine. They are as follows:· Those who are severe allergic to the vaccine or any of its components.· This vaccine should not be given to those who are pregnant or breast feeding as safety data in this group is not yet available.

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