Materiały źródłowe

• #1 Measuring immune responses to pneumococcal vaccines

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6169307/

  Quantitative assays that measure immune response to pneumococcal vaccines are not only important for the evaluation of vaccine immunogenicity and efficacy, but are also utilized in the clinical diagnosis of immune deficiency syndromes. […] Assays that measure responses to pneumococcal vaccines are important in evaluation of vaccine efficacy as well as in the diagnosis of certain immune deficiency syndromes. Such assays can be broadly divided into two categories: Assays which measure the amount of pneumococcal antibody present in serum, or functional assays that measure serum antibodies capacity to kill pneumococci. […] Evaluating response to pneumococcal vaccines is also an important component of the diagnostic evaluation of suspected primary immunodeficiency disease (PIDD). Normal or deficient responses to pneumococcal vaccines can be integrated with other clinical data to determine intact versus impaired host immunity, respectively.

• #2 Measuring immune responses to pneumococcal vaccines

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6169307/

  Assessment of vaccine response is utilized as a component in the diagnosis of common variable immunodeficiency (CVID), which is one of the most common primary immunodeficiency diseases in adults. […] To evaluate polysaccharide vaccine response, 2012 AAAAI guidelines recommend measurement of baseline pneumococcal antibody levels via a reliable quantitative technique followed by repeat measurement 48 weeks following administration of PPV23. […] A normal response to diagnostic vaccination is defined as conversion to a protected concentration (1.3 g/mL) with a 2-fold rise in antibody concentration in at least 70% of serotypes tested. […] WHO ELISA was refined and standardized primarily as a method for evaluation of vaccine immunogenicity. However, use of ELISA for diagnosis of immune deficiency syndromes was impractical, as the assay had to be performed many times in order to measure responses to each of the individual serotypes included in PPV23.

• #3 Measuring immune responses to pneumococcal vaccines

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6169307/

  Multiplex bead array assays have come to be widely utilized for evaluation of suspected immune deficiency. However, there is mounting evidence to suggest that issues of specificity and correlation with prior methods may limit their application for this purpose. […] In light of the limitations of current methods as described above, OPA has become attractive as a potential diagnostic test for PIDD.

• #4 Pneumococcal Vaccines – Medical Clinical Policy Bulletins | Aetna

  https://www.aetna.com/cpb/medical/data/1_99/0037.html

  Aetna considers quantitation of Streptococcus pneumoniae antibody (IgG) to assess impaired antibody response to pneumococcal polysaccharide vaccine medically necessary to diagnose immunodeficiency syndromes in persons with recurrent bacterial infections, and to assess their eligibility for parenteral immunoglobulin replacement (see CPB 0206 – Parenteral Immunoglobulins). […] Aetna considers quantitation of Streptococcus pneumoniae antibody experimental, investigational, and unproven for diagnosing pneumococcal infections and for all other indications because its clinical value for these indications has not been established.

• #5 Accuracy of composite diagnostic standards for pneumococcal pneumonia in vaccine trials | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/accuracy-of-composite-diagnostic-standards-for-pneumococcal-pneumonia-in-vaccine-trials/EC4035181F436946B5C0F4642663B202

  Because of a lack of gold standard diagnostics, a combination of multiple diagnostic tests, or composite diagnostic standard, has been used to measure pneumococcal pneumonia (PP) in pneumococcal vaccine trials. […] The estimated values of sensitivity and minimum specificity of composite diagnostic standards varied substantially between trials: 48.4% to 98.1% and 71.0% to 97.3%, respectively. […] Pneumococcal vaccine efficacy estimates are uncomparable and their pooled estimates are biased. […] One of the major limitations in pneumococcal vaccine trials is a lack of gold standard diagnostics for PP. […] To overcome this limitation, pneumococcal vaccine studies often use a composite diagnostic standard: pneumonia patients are screened by multiple diagnostic tests and the diagnosis of PP is made if any of the tests show positive result.

• #6 Accuracy of composite diagnostic standards for pneumococcal pneumonia in vaccine trials | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/accuracy-of-composite-diagnostic-standards-for-pneumococcal-pneumonia-in-vaccine-trials/EC4035181F436946B5C0F4642663B202

  The use of inaccurate diagnostic test underestimates true vaccine efficacies. […] In this study, we demonstrated that: (1) different combinations of diagnostic tests have been used to measure PP in pneumococcal vaccine trials; and (2) the estimated accuracy of composite diagnostic standards substantially varied by trials. […] Our findings indicate that pneumococcal VE estimates against PP are not directly comparable between RCTs. […] In conclusion, the accuracy of composite diagnostic standards for PP varies by RCTs because of the use of different combinations of imperfect tests. Without standardizing the outcome measurement, pneumococcal VE estimates are uncomparable and their pooled estimates are biased.

• #7 Diagnosis of Invasive Pneumococcal Infection by Serotype-Specific Urinary Antigen Detection

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1248490/

  Widespread use of conjugate pneumococcal polysaccharide-protein vaccines may alter the spectrum of pneumococci producing invasive disease. […] Novel sensitive diagnostic methods would be valuable for monitoring the epidemiology of pneumococcal disease within populations and vaccine recipients. […] The diagnosis of Streptococcus pneumoniae infection is frequently problematic. […] New sensitive diagnostic methods would be valuable not only for determining the etiology of individual infections but also for monitoring the epidemiology of pneumococcal disease within the general population and vaccine recipients in particular. […] We report here the development and clinical application of serotype-specific enzyme-linked immunosorbent assays (ELISA) for the detection of capsular polysaccharide in urine.

• #8 Pneumococcal Disease

  https://www.healthhub.sg/a-z/diseases-and-conditions/topic_pneumococcal_disease

  Pneumococcal disease diagnosis is performed by isolating the bacteria from the blood, spinal fluid, lungs or other body fluids. […] For non-invasive pneumococcal disease, such as pneumonia or otitis media, a physical examination and X-rays are required.

• #9 Diagnosis of Invasive Pneumococcal Infection by Serotype-Specific Urinary Antigen Detection

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1248490/

  The method described above has a high sensitivity for the serotypes in the test panel and very high specificity among adults with invasive pneumococcal disease and patients with community-acquired nonpneumococcal bacteremia. […] The method as described above would fail to detect approximately 20% of patients with invasive disease caused by pneumococcal serotypes other than those in the test panel, but if used in conjunction with a sensitive test for C polysaccharides, it should prove to be a successful method of determining the etiology of the majority of serious pneumococcal diseases in adults. […] The panel also covers the major causes of invasive pneumococcal infections both in the United Kingdom and internationally. […] The use of serotype-specific assays for pneumococcal antigen detection in urine has been reported in three previous publications, but all those publications reported markedly lower sensitivity than observed in this study. […] Our data indicate that the Binax NOW Streptococcus pneumoniae urinary antigen test would be a suitable complementary method for the rapid screening of urine samples.

• #10 Antigen assay aids pneumococcal pneumonia diagnosis | Respiratory Therapy

  https://respiratory-therapy.com/disorders-diseases/infectious-diseases/other-infections/antigen-assay-aids-pneumococcal-pneumonia-diagnosis/

  A pleural antigen assay (NOW, Binax) can supplement standard diagnostic methods for detecting pneumococcal pneumonia, Spanish researchers report in the May issue of Chest. […] The NOW test, the researchers note, was developed in order to provide a rapid urinary assay for detecting pneumococcal cell wall components common to all serotypes. […] The sensitivity of the NOW pleural test was higher than that obtained for blood (37.5%) and pleural fluid cultures (32.3%), but lower than the detection of pneumococcal antigen in urine samples (82.1%). […] Given these findings, the researchers conclude that this rapid immunochromatographic test used on pleural samples „augments conventional microbiological methods used for the etiologic diagnosis of pneumonia.”

• #11 Pneumococcal Vaccine Recommendations | Pneumococcal | CDC

  https://www.cdc.gov/pneumococcal/hcp/vaccine-recommendations/index.html

  CDC recommends pneumococcal vaccination for children younger than 5 years and adults 50 years or older. […] CDC also recommends pneumococcal vaccination for children and adults at increased risk for pneumococcal disease. […] CDC recommends routine pneumococcal vaccination for all children younger than 5 years old. […] Administer PCV15, PCV20, or PCV21 for all adults 50 years or older. […] If PCV15 is used, administer a dose of PPSV23 one year later, if needed. Their pneumococcal vaccinations are complete. […] If PCV20 or PCV21 is used, a dose of PPSV23 isn’t indicated. Regardless of which vaccine is used (PCV20 or PCV21), their pneumococcal vaccinations are complete. […] In certain situations, children 2 through 18 years of age may need additional pneumococcal vaccine doses. In addition, adults younger than age 50 years of age may be recommended to receive pneumococcal vaccines. […] Risk-based indications for pneumococcal vaccination vary by patient age. The type of vaccine and number of doses can also vary by age and vaccination history.

• #12 Pneumococcal vaccine – NHS

  https://www.nhs.uk/vaccinations/pneumococcal-vaccine/

  The pneumococcal vaccine helps protect against serious illnesses like pneumonia and meningitis. […] The pneumococcal vaccine is recommended for babies, older people, and people at higher risk of getting seriously ill from pneumococcal infections. […] You’re at higher risk of getting seriously ill from pneumococcal infections if you have: sickle cell disease, coeliac disease, problems with your spleen or you’ve had your spleen removed, a long-term condition that affects your breathing such as chronic obstructive pulmonary disease (COPD) or cystic fibrosis, a long-term condition that affects your heart such as coronary heart disease or heart failure, chronic kidney disease, a long-term condition that affects your liver such as cirrhosis, diabetes, a weakened immune system due to a condition such as HIV, or a treatment such as steroid medicine or chemotherapy, a condition where fluid that protects the brain and spinal cord leaks out (cerebrospinal fluid leaks), cochlear implants.

• #13 Pneumococcal vaccine – NHS

  https://www.nhs.uk/vaccinations/pneumococcal-vaccine/

  Most people can have the pneumococcal vaccine if they need it, including if you’re pregnant or breastfeeding. […] You only cannot have the vaccine if you’ve had a serious allergic reaction (anaphylaxis) to a previous dose of the vaccine or an ingredient in the vaccine. […] Your GP surgery will usually contact you if you or your child are eligible for the pneumococcal vaccine. […] You can get the pneumococcal vaccine at the same time as other vaccines, such as the flu vaccine. […] Vaccination gives the best protection against pneumococcal infections.

• #14 Pneumonia vaccine | Health & wellness | UnitedHealthcare

  https://www.uhc.com/health-and-wellness/health-topics/vaccines/pneumonia-vaccine

  Its important to know the pneumonia vaccine only helps protect against pneumococcal pneumonia. […] Its recommended that kids younger than 2 and adults older than 65 get the pneumonia vaccine. […] It is also recommended that individuals with certain underlying health conditions get vaccinated to help protect themselves from invasive pneumococcal disease. […] According to the Centers for Disease Control and Prevention (CDC), there have been studies and clinical trials that show the following: Getting at least 1 shot of the pneumonia vaccine helps protect at least 8 in 10 babies from serious infection from invasive pneumococcal disease, 3 in 4 adults 65 and older against pneumococcal disease, and 9 in 20 adults 65 and older against pneumococcal pneumonia. […] Getting 1 shot of pneumonia vaccine helps protect between 6 to 7 in 10 healthy adults against invasive pneumococcal disease.

• #15

  https://historyofvaccines.org/diseases/pneumonia-pneumococcal-disease/

  A pneumococcal vaccine that protected against 14 strains was licensed in 1977, and expanded to protect against 23 strains in 1983. This vaccine is a polysaccharide vaccine called PPSV23 (brand name Pneumovax 23, manufactured by Merck). However, it is most effective in adults, and does not consistently generate immunity in children younger than two years old. […] A separate vaccine for children called PCV7 was licensed in 2000. PCV7 is a conjugate vaccine; it was expanded to include protection against 13 strains in 2010, and renamed PCV13 (brand name Prevnar 13, manufactured by Pfizer). PCV13 protects against the bacterial strains responsible for the most severe childhood pneumococcal infections. […] PCV7 was added to the recommended childhood vaccination schedule in 2000 (PCV13 replaced it on the schedule in 2010). Since the initial recommendation, invasive pneumococcal disease in children has dropped by nearly 80% in the United States.

• #16 LAC | DPH – Vaccine Preventable Disease Control Program

  http://ph.lacounty.gov/ip/diseases/pneumococcal/index.htm

  Studies have also shown PPSV23 protects 7 in 10 adults with healthy immune systems from invasive pneumococcal disease. […] Talk to your healthcare provider to see which pneumococcal vaccine is right for you. […] CDC recommends routine pneumococcal vaccination for all children younger than 5 years old. […] CDC recommends routine pneumococcal vaccination (PCV15, PCV20, or PCV 21) for all adults 50 years and older who have never received PCV vaccine, or their vaccination history is unknown. […] Pneumococcal vaccine is also recommended for children and adults at increased risk for pneumococcal disease. […] CDC estimates that rates of invasive pneumococcal disease (IPD) in children less than 5 years have decreased by 95% since the introduction of PCVs. Rates of IPD in adults also decreased after routine vaccination with PCV was recommended for children.

• #16 LAC | DPH – Vaccine Preventable Disease Control Program

  http://ph.lacounty.gov/ip/diseases/pneumococcal/index.htm

  Pneumococcal conjugate vaccine helps protect against bacteria that cause pneumococcal disease. […] The different vaccines are recommended for different people based on age and underlying health conditions. […] Pneumococcal vaccines help protect against serious pneumococcal disease. […] Vaccination is the best way to prevent invasive pneumococcal disease. CDC recommends pneumococcal vaccination for: […] Pneumococcal disease rates have decreased dramatically since the United States began using PCVs. […] PCV15, PCV20, and PCV21 are new vaccines, so there is no data on how well these vaccines work in real-world conditions. […] Studies show that PCV13 prevented invasive pneumococcal disease caused by vaccine serotypes. […] PCV13 also prevented antibiotic-resistant pneumococcal infections caused by vaccine serotypes.

• #17 Differential Diagnosis: Pneumococcal Pneumonia Versus Other Etiologies

  https://www.pharmacytimes.com/view/differential-diagnosis-pneumococcal-pneumonia-versus-other-etiologies

  As were looking at or working up a patient that might be suffering or might be infected by pneumococcal pneumonia, the question comes up, how we differentiate that from other respiratory infections like COVID-19? […] The first thing is, of course, were going to be concerned with a number of different viral infections, including influenza in the winter season. […] It is generally assumed that the most common bacterial cause of pneumonia that we see in a doctors office is still caused by pneumococci. […] So how do we diagnose pneumococcal infections, particularly community-acquired pneumococcal infections? […] The laboratory does its job and tells us that there are pneumococci present. Does that indicate that youve had pneumococcal pneumonia? It makes it more likely, but we have to remember that many of us can carry asymptomatically pneumococci in our throats.

• #18 Differential Diagnosis: Pneumococcal Pneumonia Versus Other Etiologies

  https://www.pharmacytimes.com/view/differential-diagnosis-pneumococcal-pneumonia-versus-other-etiologies

  If the gram stain shows a lot of polys, and polys that are magnetizing pneumococci, its more likely that youve got pneumococcal pneumonia. […] Now that said, if youre ill enough to get a blood culture and the blood culture is positive, thats the gold standard. Then everyone would agree that youve got a pneumococcal infection. […] Nonetheless, many physicians will go ahead and treat patients presumptively. […] We need to look at symptoms. We need to look at history. Is this person at risk for invasive pneumococcal disease? […] Its very similar to some of our other infections. Anywhere from 48 to 72 hours is common. […] I think that goes back to whether or not they are having respiratory symptoms. […] But weve really seen during the pandemic that we dont want to miss that critical window where somebody may be able to convalesce at home versus them having a reduction in their oxygenation.

• #19 Differential Diagnosis: Pneumococcal Pneumonia Versus Other Etiologies

  https://www.pharmacytimes.com/view/differential-diagnosis-pneumococcal-pneumonia-versus-other-etiologies

  Are they immunocompromised? Are they older? Do they have 2 or 3 underlying chronic illnesses? […] Its really a fine line between them being able to convalesce at home, being able to provide antibiotics, or a course of therapy vs really requiring that additional supportive care that may need to be supplemental oxygen before they get to the point where they may require mechanical ventilation.

• #20 Pneumococcal Disease Tests: MedlinePlus Medical TestLock

  https://medlineplus.gov/lab-tests/pneumococcal-disease-tests/

  Pneumococcal disease tests look for these bacteria in your: […] Pneumococcal disease tests are used to find out whether you have pneumococcal disease. […] Symptoms of pneumococcal infections can vary, depending on which part of your body is affected. […] Your provider may order a pneumococcal culture, pneumococcal antigen test, and/or a pneumococcal PCR test to help identify the bacteria. […] The results will show whether you have pneumococcal disease. […] A positive result means that pneumococcus bacteria were found in your specimen. You most likely have pneumococcal disease. […] A negative result means that no pneumococcus bacteria were found in your specimen. Most likely, your symptoms are not caused by pneumococcal disease.

• #21 Pneumococcal Disease – CVEEP

  https://cveep.org/respiratory-disease/pneumococcal/

  Pneumococcal disease is caused by a bacteria called Streptococcus pneumoniae and can result in many different types of infections, including pneumonia (lung infection). […] The best way to help prevent pneumococcal disease is to get vaccinated. […] CDC recommends two types of pneumococcal vaccines, pneumococcal conjugate vaccines (PCVs) and pneumococcal polysaccharide vaccines (PPSVs), based on age, risk conditions, and past pneumococcal vaccination history. Talk to a healthcare provider to determine whether you should get a pneumococcal vaccine and which vaccine is right for you. […] Early diagnosis is very important for serious pneumococcal disease. Reach out to a healthcare provider for a diagnosis, which may require lab testing. […] Early treatment is very important, so consult with a healthcare provider on the best treatment plan. Providers typically use antibiotics to treat pneumococcal disease.

• #22 Pneumococcal Infections and Updates on Pneumococcal Vaccines | Pediatric Health Providers

  https://www.rwjbh.org/blog/2025/january/pneumococcal-infections-and-updates-on-pneumococ/

  Pneumococcal infections are caused by the bacteria Streptococcus pneumoniae or, simply, pneumococcus. […] The best way to prevent pneumococcal disease is by vaccination. The Centers for Disease Control and Prevention (CDC) recommends pneumococcal vaccine for all children younger than 5 years old and adults 65 years or older. Vaccination is also recommended for people 5 to 64 years old at increased risk of acquiring pneumococcal infections. […] Since the introduction of PCV7 and PCV13, there has been a significant reduction in invasive pneumococcal diseases, including pneumonia and meningitis. However, over the years, the cases of invasive pneumococcal diseases caused by non-PCV13 serotypes have increased. This led to the introduction of PCV15 (approved in 2021) and PCV20, which was approved for adults in 2021 and for children in 2023.

• #23

  https://journals.lww.com/ajg/fulltext/2023/10001/s1816_adult_patients_with_celiac_disease_are.2157.aspx

  Patients with celiac disease (CD) have an increased risk of pneumococcal infections mainly due to functional asplenia. The 2023 American College of Gastroenterology update on diagnosis and management of CD guidelines suggest pneumococcal vaccination for patients with CD. The aim of this study was to assess the frequency of pneumococcal disease vaccination in a cohort of adults with CD. […] Overall, 141 (42%) had at least 1 pneumococcal vaccine and 199 (59%) were unvaccinated. […] Patients with CD are under-vaccinated against pneumococcal disease, particularly patients 65 years old. Given the pneumococcal vaccines low cost, availability, demonstrated disease reduction in at-risk patients, and high costs of disease burden, gastroenterologists have a responsibility to recognize this gap in CD quality care and work proactively to improve pneumococcal disease vaccination rates in patients with CD.

• #24 Effectiveness of Pneumococcal Vaccines | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0501/od3.html

  How effective are pneumococcal polysaccharide vaccines in preventing pneumonia in adults? […] The 23-valent pneumococcal polysaccharide vaccine (PPSV23; Pneumovax 23) decreases the relative risk of community-acquired pneumonia in adults by 13%. […] PPSV23 also lowers the risk of pneumonia in nursing home residents, but not in community-dwelling patients. […] PPSV23 should be given to all patients 65 years and older and to younger patients with comorbidities such as chronic heart or lung disease. […] The diagnosis of pneumonia was made by clinical symptoms and chest radiography. […] Limitations included lack of standardization for the diagnosis of pneumonia. […] Limitations included different methods of laboratory testing to confirm the diagnosis of pneumococcal pneumonia. […] The Advisory Committee on Immunization Practices recommends PPSV23 for all patients 65 years and older, and for younger patients with comorbid or immunocompromising conditions.

• #25 Childhood Pneumonia: Vaccines, Diagnostics, and Treatment

  https://www.gatesfoundation.org/our-work/programs/global-health/pneumonia

  Childhood deaths from pneumonia are preventable using existing vaccines, diagnostic tools, and treatments. […] We work to improve the development and delivery of pneumonia vaccines and expand the use of antibiotic treatments and diagnostic tools. […] Because vaccines cannot prevent all cases of pneumonia and because the incidence of this disease remains high, we also work to improve access to appropriate diagnostic and treatment options in public and private health care systems. […] Nearly half of early childhood deaths from pneumonia are estimated to result from lack of or delay in appropriate diagnosis and treatment. […] We invest in the collection and use of high-quality data on the causes and global burden of pneumonia, which will contribute directly to vaccine development, better treatments, improved service delivery, innovation in diagnostics and treatment, and better reporting on causes of death.

• #26 Pneumococcal Disease – NFID

  https://www.nfid.org/infectious-disease/pneumococcal/

  Pneumococcal vaccination is recommended for: […] In the US, there are 2 types of pneumococcal vaccines (conjugate and polysaccharide) currently available. […] Vaccine recommendations vary by age and risk group. […] Talk with a healthcare professional about pneumococcal vaccination. […] The Centers for Disease Control and Prevention has an app to help determine which pneumococcal vaccines a patient needs and when. […] COVID-19 vaccines may be administered on the same day as pneumococcal vaccines, but each vaccine should be injected in a different site. […] Antibiotics are used to treat pneumococcal disease. However, pneumococcal bacteria can be resistant to treatment with 1 or more antibiotics commonly used for treatment.

• #27 Pneumococcal vaccine | NHS inform

  https://www.nhsinform.scot/healthy-living/immunisation/vaccines/pneumococcal-vaccine/

  The pneumococcal vaccine provides some protection against illnesses caused by pneumococcal bacteria. […] The pneumococcal vaccine provides some protection against the serious conditions caused by pneumococcal bacteria. These conditions include: […] The pneumococcal vaccine is available in Scotland for all people aged 65 and over. […] People aged 65 or over only need a single dose of the vaccine, which will help protect them for life. […] The Pneumococcal Polysaccharide vaccine is routinely used in Scotland. […] All medicines (including vaccines) are tested for safety and effectiveness before theyre allowed to be used. Their safety continues to be monitored while in use by the Medicines and Healthcare products Regulatory Agency (MHRA). The vaccine meets the high safety standards required for it to be used in the UK and other European countries. The vaccine has been given to millions of people worldwide. […] The pneumococcal vaccine is the best way to protect yourself against the diseases and conditions caused by the pneumococcal bacteria.

• #28 Coding Pneumococcal Vaccination for Medicare Beneficiaries

  https://www.physicianspractice.com/view/coding-pneumococcal-vaccination-medicare-beneficiaries

  For example, if a beneficiary who is 65 years or older received the 23-valent pneumococcal polysaccharide vaccine (PPSV23) a year or more ago, then the 13-valent pneumococcal conjugate vaccine (PCV13) should be administered next as the second in the series of the two recommended pneumococcal vaccinations. […] The ICD-9-CM diagnosis codes pneumonia vaccine prophylaxis is V03.82 Pneumococcal prophylaxis. In ICD-10 (scheduled for implementation Oct. 1, 2015), all immunization encounters will have Z23 Encounter for immunization as the primary diagnosis; procedure codes will identify the type(s) of immunizations given.

• #29 Coding: Medicare Part B and Part D Vaccine Coverage | AAFP

  https://www.aafp.org/family-physician/practice-and-career/getting-paid/coding/medicare-vaccine-coverage.html

  Medicare Part B provides preventive coverage only for certain vaccines. These include: […] Pneumococcal: (codes 90670, 90732, once per lifetime with high-risk booster after 5 years) […] The diagnosis code to report with these preventive vaccines is: […] Z23 Encounter for immunization […] The influenza and pneumococcal vaccines and the administration of these vaccines are not subject to the Medicare Part B deductible or co-insurance. Medicare pays at 100% of the allowable amounts. […] Medicare will pay two administration fees if a beneficiary receives both the influenza virus and the pneumococcal vaccine on the same day. […] This includes all preventive vaccines not covered under Medicare Part B.

• #30 Specific antibody deficiency | Immune Deficiency Foundation

  https://primaryimmune.org/understanding-primary-immunodeficiency/types-of-pi/specific-antibody-deficiency

  Problems with specific antibody production may be suspected in children and adults who have a history of recurrent infections of the ears, sinuses, bronchi, and/or lungs. […] If isolated low antibody levels to Streptococcus pneumoniae are found during the initial evaluation, a pneumococcal vaccine (Pneumovax) is administered and follow-up levels are measured. […] Individuals older than 1 year of age may be immunized with the pneumococcal polysaccharide vaccine (Pneumovax 23 or Pnuimmune 23). […] Antibody levels are measured again 4-6 weeks later to determine if adequate protective antibody levels were produced. […] For therapy, it is also possible to re-immunize with Prevnar 13, a conjugate type of pneumococcal vaccine, which, for most, may be more immunogenic than Pneumovax. […] When interpreting pneumococcal levels, it is important to recognize the variability in testing methodology and subsequent results that may occur among different labs.

• #31 Childhood Pneumonia: Vaccines, Diagnostics, and Treatment

  https://www.gatesfoundation.org/our-work/programs/global-health/pneumonia

  We also work to raise the profile of pneumonia as a critical child health issue. Our priorities include ensuring sufficient funding for critical vaccines, supporting vaccine and child health advocates, and building political will at the global and country levels for evidence-based pneumonia prevention and treatment. […] We work closely with other teams at the foundation to improve access to effective treatments for children with pneumonia, with a special focus on Nigeria, northern India, Ethiopia, the Democratic Republic of the Congo, and Pakistan—the countries with the greatest number of pneumonia deaths.

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