AAP Makes Recommendations for Pneumococcal Vaccines in At-Risk Children

Pneumococcal conjugate vaccines have reduced the rates of invasive pneumococcal disease directly in vaccinated children and indirectly through herd immunity in unvaccinated populations. In a new policy statement, “Immunization for Streptococcus pneumonia Infections in High-Risk Children,” in the December 2014 issue of Pediatrics (published online Nov. 24), the American Academy of Pediatrics (AAP) provides recommendations for the use of pneumococcal vaccines (PCV13), in children 6 through 18 years of age. After PCV vaccines were introduced, widespread reductions in invasive pneumococcal disease attributable to vaccine serotypes were seen in young children. However, older children with immunodeficiency and other high-risk conditions continued to experience invasive pneumococcal disease, illustrating the need for new vaccine recommendations to include these populations. The new recommendations from the AAP include giving a single dose of PCV13 to children 6 through 18 years of age who have immunocompromising conditions, including HIV and sickle cell disease. Children in this group who have not previously been vaccinated with the pneumococcal polysaccharide vaccine (PPSV23) should receive a dose ≥8 weeks after the initial dose of PCV13. Recommendations for the use of PCV13 and PPSV23 in healthy children remains unchanged from previous AAP policy.




The American Academy of Pediatrics is an organization of 62,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org.

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