4 Pediatric Pneumococcal Vaccine Conundrums

Throughout my 40+ years as a physician, the pediatric vaccine schedule has become increasingly complicated. When I started in 1979, a child would receive 4 shots total and 3 oral vaccines protecting againt 7 diseases in the first year of life. Today, in my office, the same-aged child will have received 13 shots and 3 oral vaccines protecting against 12 diseases in that first year.

Currently, 2 pneumococcal vaccines have been approved by the US Food and Drug Administration for use in children: Prevnar 13™ (PCV13) and Pneumovax® (PPSV23). PCV13 is recommended for all children aged <2 years; for children aged 2-18 years with specific underlying conditions, the CDC recommends both PPSV23 and PCV13.

Since I think it can still be confusing, let's look at some conundrums that can occur.