From the Guidelines
For a 24-year-old female with asthma who has never received a pneumococcal vaccine, I recommend administering a single dose of PCV20, as it provides protection against 20 strains of Streptococcus pneumoniae. This recommendation is based on the most recent guidelines from the Advisory Committee on Immunization Practices (ACIP) in 2023 1. According to the guidelines, adults aged 19-64 years with a chronic medical condition, such as asthma, should receive a single dose of PCV20 or a dose of PCV15 followed by a dose of PPSV23 at least 1 year later.
Key Points to Consider:
- Asthma is considered a chronic lung disease that increases the risk of pneumococcal disease complications, making vaccination important for this patient.
- The PCV20 vaccine provides protection against 20 strains of Streptococcus pneumoniae that commonly cause serious infections like pneumonia, meningitis, and bloodstream infections.
- The vaccine works by stimulating the immune system to produce antibodies against the bacterial capsular polysaccharides.
- Side effects are generally mild and may include soreness at the injection site, mild fever, and muscle aches that typically resolve within 48 hours.
- The patient should be informed that this vaccine can be administered during the same visit as other vaccines, including the annual influenza vaccine, which is also recommended for individuals with asthma.
Additional Recommendations:
- The patient should be monitored for any adverse reactions after receiving the vaccine.
- The patient should be educated on the importance of receiving the pneumococcal vaccine and the potential risks of not receiving it.
- The patient's vaccination record should be updated to reflect the administration of the PCV20 vaccine.
This recommendation is supported by the most recent and highest quality study available, which prioritizes the use of PCV20 for adults with chronic medical conditions, including asthma 1.
From the Research
Pneumococcal Vaccination for Asthma
- The patient is a 24-year-old girl with asthma and has not received any pneumococcal vaccine before.
- According to the study 2, there is limited evidence to support the routine use of pneumococcal vaccine in people with asthma.
- However, the study 3 suggests that the number needed to vaccinate (NNV) to prevent one case of invasive pneumococcal disease (IPD) in asthmatics is comparable to that of other high-risk conditions, warranting the addition of asthma to the list of high-risk conditions for pneumococcal vaccination.
Recommended Vaccines
- The study 4 recommends a single dose of pneumococcal conjugate vaccine (PCV) for all PCV-naïve adults aged ≥50 years, but does not specifically address the recommendation for adults aged <50 years with asthma.
- The study 5 discusses the coadministration of 13-valent pneumococcal conjugate vaccine (PCV13) and quadrivalent inactivated influenza vaccine (QIV) in adults, but does not provide guidance on pneumococcal vaccination for adults with asthma.
Vaccination Decision
- Based on the available evidence, it is unclear which specific pneumococcal vaccine is needed for a 24-year-old girl with asthma who has not received any pneumococcal vaccine before 2, 3.
- Further guidance from a healthcare professional is necessary to determine the most appropriate pneumococcal vaccination strategy for this patient.