Spectrum: Local Antimicrobial Stewardship, for Markham Stouffville Hospital

Pneumococcal Immunization Schedule

Patient Factors

The recommended schedule is based on the patient’s age and underlying condition.

Administration should be postponed in persons with severe acute illness.

Persons with minor acute illness, with or without fever, may be vaccinated.

Select Patient Group

Immunocompetent adults (18-64 years) at high risk of IPD due to an underlying medical condition

  • Chronic CSF leak

  • Chronic neurologic condition that may impair clearance of oral secretions

  • Cochlear implants

  • Chronic heart disease

  • Diabetes

  • Chronic kidney disease (CKD)*

  • Chronic liver disease, including cirrhosis from any cause*

  • Chronic lung disease, including asthma requiring medical care in the preceding 12 months

*Indicates patients with the highest risk of IPD

Immunocompetent adults (18-64 years) who are long term care residents, smokers, alcoholics, homeless, illicit drug users

Immunocompetent adults 65 years and older, regardless of risk factors or previous vaccination

Adults with immunocompromising condition, except HSCT

  • Sickle cell disease

  • Congenital/acquired asplenia,

Splenic dysfunction (see Section B)

  • Congenital immunodeficiencies involving any part of immune system

  • Immunocompromising therapy (steroids, chemotherapy, radiation therapy, post-organ transplant therapy)

  • HIV infection

  • Hematopoietic stem cell transplant (HSCT)

  • Malignant neoplasms, including leukemia, lymphoma

  • Nephrotic syndrome

  • Solid organ or islet transplant (candidate or recipient)

Adult HSCT recipients