Immunization, pneumococcal

1) the indications for which PPSV23 vaccination is recommended now include smoking and asthma, and 2) routine use of PPSV23 is no longer recommended for Alaska Natives or American Indians aged <65 years unless they have medical or other indications for PPSV23. ACIP recommendations for revaccination with PPSV23 among the adult patient groups at greatest risk for IPD (i.e., persons with functional or anatomic asplenia and persons with immunocompromising conditions) remain unchanged (cdc.gov, accessed January 25,2012). In July 2000, the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) jointly announced childhood immunization recommendations for use of the newest form of the pneumococcal vaccine. The new AAP/CDC guidelines stated that "the heptavalent pneumococcal conjugate vaccine (PCV7) is recommended for use in all children 23 months of age and younger. Although other pneumococcal vaccines are available, PCV7 represents the first pneumococcal vaccine approved for use in children younger than age 2. The policy recommends that PCV7 be given concurrently with other recommended childhood vaccines at 2, 4, 6, and 12 to 15 months. The number of PCV7 doses required depends upon the age at which vaccination is initiated. The vaccine was also recommended for all children 24 to 59 months of age who are at especially high risk of invasive pneumococcal infection. This includes children with sickle cell disease, human immunodeficiency virus (HIV) infection, and other children who are immunocompromised." Pneumococcal infections are the most common invasive bacterial infections in children in the United States. Pneumococcal infections cause about 1,400 cases of meningitis, 17,000 cases of bloodstream infections, and 71,000 cases of pneumonia every year in children under age 5.