- Pneumococcal pneumonia causes 150,000 hospitalizations each year.
- The CDC’s pneumonia vaccine guidelines have expanded to protect infants and young children from pneumococcal disease.
- Nurses and nursing students might expect to see changes in practice protocols in both inpatient and outpatient settings.
Recently, the U.S. Centers for Disease Control and Prevention (CDC) updated its pneumonia vaccine recommendations for infants and young children. Explore how these changes may affect nurses’ role in caring for pediatric patients.
New CDC Pneumonia Vaccine Guidelines: What’s Different?
The newest CDC pneumonia vaccine recommendations provide broader protection for infants and young children under age two.
Although commonly referred to as the “pneumonia” vaccine, the pneumococcal vaccine fights against streptococcus pneumoniae (or pneumococcus), a bacteria that can cause more than just a lung infection.
Pneumococcus can cause infections in the ear, sinuses, blood, and structures of the brain and spinal cord (i.e., meningitis). There are over 100 serotypes (or strains) of the pneumococcus bacteria but only a minority cause most infections.
According to the CDC, pneumococcal pneumonia causes 150,000 hospitalizations each year. In 2019, pneumococcal meningitis and bacteremia (blood infection) caused 3,250 deaths. In children under age five, pneumococcus is the leading cause of bacterial meningitis.
The CDC recommends four types of pneumococcal vaccines targeted to vulnerable groups, including infants, children, older adults, and adults with pre-existing medical conditions and risk factors. Age and medical history determine which person receives a particular vaccine type.
Current CDC pneumonia vaccine recommendations:
- Pneumococcal conjugate vaccine 13 (PCV13) — covers 13 serotypes
- Pneumococcal conjugate vaccine 15 (PCV15) — covers 15 serotypes
- Pneumococcal conjugate vaccine 20 (PCV 20) — covers 20 serotypes
- Pneumococcal polysaccharide vaccine 23 (PPSV23) — covers 23 serotypes
While PPSV23 covers the most serotypes, the vaccine is not recommended for infants and children under two years of age. The vaccine with the next highest serotype coverage — PCV20 — had only been approved for adults and children two years of age and older until now.
As of June 2023, the CDC approved PCV20 for infants and young children (from 2-23 months of age).
In Light of the New CDC Guidelines, What Should I Do Differently in the Clinic?
Nurses and nursing students might anticipate implementation of new practice protocols, particularly for those who work in outpatient pediatric clinics, urgent and emergency care facilities, and inpatient hospital postpartum, neonatal, and pediatric units.
New Recommendations for Nurses
Gather a detailed past medical history (PMH)
To assist pediatric providers in determining if the new vaccine is indicated for a particular patient, nurses may be expected to follow specific guidelines when gathering a patient’s past medical history (PMH) from parents and guardians. PMH may include previous vaccines, allergies, recent illnesses, and chronic medical conditions. For example, infants who have had severe reactions to any diphtheria-toxoid-containing vaccine in the past should not receive a PCV vaccine of any type.
Provide updated patient education when administering new vaccine
Federal law requires clinicians to provide the most current vaccine information in the form of vaccination information sheets (VIS) to patients when administering vaccines. Nurses will be required to provide this education to parents and guardians before and after administering the new vaccine. Facilities may push for accurate and timely documentation of the education that was provided.
Encourage provider follow up for new vaccination
Nurses working in urgent/emergency, postpartum, neonatal, and pediatric care settings may be expected to inform parents and guardians of the new vaccine update. Nurses might anticipate giving instructions on when to follow up with a pediatric provider for vaccine administration. When discharging neonatal and pediatric patients, nurses might expect to see discharge paperwork that includes the new update.