Pneumonia Vaccine Warnings and Precautions

The pneumonia vaccine should be given at least two weeks before starting chemotherapy. Warnings and precautions with the pneumonia vaccine also apply to anyone with a bleeding disorder and to women who are pregnant, thinking of becoming pregnant, or breastfeeding. The vaccine should be avoided by anyone who has had a serious reaction to it (or to any of its ingredients) in the past.

What Should I Tell My Healthcare Provider?

Before you receive the pneumonia vaccine (Pneumovax®, Prevnar 13®) talk to your healthcare provider if you have:
  • Had any sort of a reaction to a vaccine before
  • A moderate or severe illness
  • Guillain-Barré syndrome
  • A history of febrile seizures
  • Chronic cerebrospinal fluid leakage due to a skull fracture, brain surgery, or any other cause
  • A bleeding disorder (or are taking an anticoagulant)
  • An immune-suppressing condition such as HIV or AIDS, diabetes, or cancer
  • Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Make sure to tell the healthcare provider giving the injection about any medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Warnings and Precautions With the Pneumonia Vaccine

Warnings and precautions to be aware of prior to receiving the pneumonia vaccine include the following:
  • The pneumonia vaccine does not protect against all types of Streptococcus pneumoniae, and it certainly does not provide protection against infections caused by viruses or other types of bacteria.
  • Care must be used when giving any intramuscular injection (including vaccines) to individuals with bleeding disorders or who are taking anticoagulant medications ("blood thinners"). In some cases, the healthcare provider may decide that the risk of the injection is not worth the benefit. Pneumovax can be given intramuscularly or subcutaneously (just under the skin), but Prevnar 13 must be given intramuscularly.
  • Febrile seizures (seizures associated with high fevers in young children) have been associated with Prevnar 13 in rare cases. If your child has a tendency to get febrile seizures, ask your healthcare provider if you should give an antifever medication such as acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®) to help avoid this problem.
  • If you have an immune-suppressing condition, the pneumonia vaccine may not be as effective as usual for protection against pneumococcal disease.
  • Pneumovax may not be effective for preventing bacterial meningitis in individuals with chronic cerebrospinal fluid leakage, such as people with a skull fracture.
  • Neither of the pneumonia vaccines contains thimerosal (a mercury-containing preservative). People who are concerned about exposure to this substance can be confident that these vaccines have no thimerosal -- not even trace amounts.
  • Some people also are concerned about the aluminum content of vaccines. While Pneumovax contains no aluminum, Prevnar 13 contains 0.125 mg of aluminum per dose. Also, these vaccines are not made from animal components or human fetal cell lines, unlike some vaccines.
  • You can receive the pneumonia vaccine if you have a mild illness, such as the common cold. However, it is usually best to postpone the vaccination in the case of a moderate or severe illness.
  • Make sure your healthcare provider knows if you have ever had any serious reactions (including Guillain-Barré syndrome) to any vaccines before.
  • If you will be having chemotherapy, radiation, or a splenectomy (surgical removal of the spleen), appropriate timing of Pneumovax is important. It should be given at least two weeks ahead of time, if possible.
  • These vaccines are considered pregnancy Category C medications. This means it is unknown if they are safe for use during pregnancy (see Pneumovax and Pregnancy). Prevnar 13 is approved only for young children or older adults, and is unlikely to be given to a pregnant woman.
  • As with most vaccines, the pneumonia vaccine is considered safe for breastfeeding women (see Pneumovax and Breastfeeding). Prevnar 13 is approved only for young children or older adults and is unlikely to be given to a breastfeeding woman.
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