CC January 2015 New PCV-13 recommendations

echoecho's version from 2015-05-14 05:43


Question Answer
Describe steptococcu pneumoniae?a gram-positive coccus with > 90 subtypes spread by airborne water droplets
Invasitve pneumococcal disease (IPD) includes what 3 diseases, affects both adults and children?1. pneumonia 2. bacteremia 3. meningitis
What 2 age groups are at highest risk?1. < 2 y.o. 2. > 65 years
List 2 vaccine types that are available?1. polysaccharide 2. conjugate
The first conjugate vaccine (PCV) was introduced in 2000, the currently used ____-valent vaccine was introduced in 2010?13
PCV-13 has been used primarily in children, although it has been also recommended for what groups of adults?ESRD, asplenia, HIV, solid organ transplant, some malignances
List the indications for 23-valent polysaccharide vaccine (PPSV)?1. individuals > 2 years of age with certain medical conditions (chronic renal failure, sickle cell disease, anatomic or functional asplenia) 2. adults > 65 years of age 3. adults < 65 years of age w/ certain med conditions (smoking, chronic lung disease, diabetes, immunocompromise)
***In late 2014, the ACIP recommended that PCV-13 be routinely administered to adults > ____ years of age?65
The above recommendation is based on a study of 85,000 pneumonoccal vaccine-naive patients > 65 years of age. Half were vaccinated with PCV-13 while half received placebo. The vaccinated group had _____% fewer episodes of vaccine-type community-acquired pneumonia and a ___% reduction in invasive pneumococcal disease (IPD) compared to the placebo group?45%; 75%
Tests measuring antibody development with PCV-13 found it to be as good or better than PPSV-23, true or false?true
20-25% of IPD and 10% of community-acquired pneumonia are estimated to be caused by pneumococcal subtypes covered by the _____ vaccine and so are potentially preventable?PCV-13
In 2013, however, an estimated 38% of IPD in adults > 65 y.o. was caused by subtypes unique to PPSV-23, making what important conclusion?the administration of both vaccines important
*** Adults who received PCV-13 prior to ____ years of age do NOT need another dose?65
List the ACIP recommendations for pneumococcal vaccination > 65 y.o.?1. pneumococcal vaccine naive (give PCV-13 first, followed by PPSV-23 about 6-12 months later or at the next visit if out of the window; minimal acceptable interval between doses is 8 weeks) 2. Previously vaccinated with PPSV-23 (give PCV-13 no sooner than 1 year after the most recent dose of PPSV-23) 2. previously vaccinated with PPSV-23 before age of 65 years and are now 65 years of age (give PCV-13 no sooner than 1 year after the most recent dose of PPSV-23 and about 6-12 months later give a subsequent PPSV-23 dose (but no sooner than 5 years after the most recent PSV-23 dose)
Problematic with payment for both PCV-13 and PPSV-23, why?because Medicare currently pays for only one pneumococcal vaccine after 65 years of age.
If a pt of Medicare age previously received PPSV-23, will the second dose of PCV-13 be covered?no
Payment for PCV-13 in a vaccine-naive pt will be covered, but will the subsequent PPSV-23 dose be?no