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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Indications for pneumococcal vaccination in adults in the United States

Indications for pneumococcal vaccination in adults in the United States
All adults ≥65 years of age
Adults 19 to 64 years of age with any of the following:
  • Predisposing medical conditions:
    • Alcohol use disorder
    • Chronic heart disease*
    • Chronic lung disease
    • Chronic liver disease
    • Diabetes mellitus
    • Sickle cell disease or other hemoglobinopathies
    • Current cigarette smoking
  • Increased risk of meningitis:
    • Cerebrospinal fluid leak
    • Cochlear implant
  • Immunocompromising conditions and other conditions associated with altered immunocompetenceΔ:
    • Congenital or acquired immunodeficiency
    • Generalized active malignancy
    • Human immunodeficiency virus infection§
    • Iatrogenic immunosuppression¥
    • Hodgkin disease
    • Leukemia
    • Lymphoma
    • Multiple myeloma
    • Solid organ transplant
    • Chronic kidney disease and nephrotic syndrome
    • Functional or anatomic asplenia
  • History of invasive pneumococcal disease
Pneumococcal vaccination is indicated for adults with risk factors for acquisition of or severe adverse outcomes from pneumococcal disease. These adults should receive either PCV20 alone or PCV15 followed by PPSV23. When administering the PCV15 and PPSV23 combination, PCV15 should be given first when possible. The recommended intervals between the two vaccines vary based on sequence and indication. Refer to the UpToDate topic on pneumococcal vaccination in adults for additional detail.

ACIP: Advisory Committee on Immunization Practices; HIV: human immunodeficiency virus; PCV20: 20-valent pneumococcal conjugate vaccine; PCV15: 15-valent pneumococcal conjugate vaccine; PPSV23: 23-valent pneumococcal polysaccharide vaccine.

* Including congestive heart failure and cardiomyopathies, excluding hypertension.

¶ Including chronic obstructive pulmonary disease, emphysema, and asthma.

Δ Some UpToDate authors differ from ACIP guidance on vaccine selection for immunocompromised individuals. Refer to the UpToDate topic on pneumococcal vaccination in adults for additional information.

◊ Includes B (humoral) or T lymphocyte deficiency, complement deficiencies (particularly C1, C2, C3, and C4 deficiencies), and phagocytic disorders (excluding chronic granulomatous disease).

§ HIV infection is an indication for pneumococcal vaccination, regardless of CD4 cell count.

¥ Treatment with any immunosuppressive drugs (including long-term glucocorticoids, tumor necrosis factor alpha inhibitors, cancer chemotherapy, and other cytokine inhibitors) or radiation therapy.

‡ Chronic kidney disease is defined as glomerular filtration rate <60 mL/min/1.73 m2 for ≥3 months.

† The United States Centers for Disease Control and Prevention ACIP does not mention individuals with a prior history of invasive pneumococcal disease in their recommendations on pneumococcal vaccinations. We suggest pneumococcal vaccination in this population due to their increased risk for recurrent pneumococcal disease. Refer to the UpToDate topic on pneumococcal vaccination in adults for additional detail.
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