Regarding “Pneumonia” Vaccine....

The parents of a 2-month-old male diagnosed with sickle cell disease want to know more about “pneumonia” vaccine. When discussing this vaccine with the parents, which of the following is true?

A. High-risk infants should receive the 23-valent pneumococcal vaccine.
B. Heptavalent pneumococcal vaccine alone is recommended for high-risk children older than age 2 years.

C. Children with sickle cell disease or asplenia who receive the pneumococcal vaccine still require antibiotic prophylaxis.
D. Pneumococcal vaccine is not recommended for healthy infants.
E. Pneumococcal vaccine may not be administered at the same time as MMR, varicella, or poliovirus vaccines.

Answer : C. Children with sickle cell disease or asplenia who receive the pneumococcal vaccine still require antibiotic prophylaxis.

Discussion: All infants and children younger than age 2 years should receive the heptavalent pneumococcal vaccine. The 23-valent pneumococcal vaccine should not be given to infants since it is not immunogenic in infants. High-risk children older than the age of 2 years, such as those with sickle cell disease or asplenia, should also receive the heptavalent vaccine and the vaccine may be offered to lower risk children older than the age of 2 years. The 23-valent vaccine is recommended for high-risk children after age 2 along with the heptavalent vaccine. High-risk children also require booster doses of the 23-valent vaccine every 3 to 5 years after the initial dose. For lower risk children who are older than the age of 2 years, the heptavalent or 23-valent vaccine may be given as a single dose. When administering a heptavalent vaccine series, all repeat doses of the vaccine should be given at least 6 to 8 weeks apart. The heptavalent vaccine may be given concurrently but at different sites than MMR, varicella, and poliovirus vaccines. 

Children with sickle cell disease or asplenia require antibiotic prophylaxis up to the age of 5 years even if they have received the pneumococcal vaccines. After age 5, those who have been vaccinated may discontinue antibiotic prophylaxis.