PNEUMOVAX 23 is a vaccine indicated for active immunization for the prevention of pneumococcal disease caused by the 23 serotypes contained in the vaccine (1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F, and 33F).

Patient Vaccination Strategies for Pharmacists

Talk to Your Patients at Increased Risk About Pneumococcal Disease

As a pharmacist, your recommendation plays an important role in helping protect your patients against pneumococcal disease. You can have a positive effect by considering these 4 steps:22, 23

  • Identify
  • Initiate
  • Educate
  • Recommend and vaccinate

Video Transcript | How to Talk to Your Patients at Increased Risk About Pneumococcal Disease

Voice-Over:

This presentation has been created and paid for by Merck Sharp & Dohme Corp, a subsidiary of Merck & Co., Inc.

Dr. Cota:

Hello and welcome to the “Time to…” Merck video series. I’m Dr. Cota, a specialty pharmacist and infectious disease expert at the University of the Incarnate Word Feik School of Pharmacy in San Antonio, Texas. In this segment, we will explore how to talk with your patients under age 65 with certain chronic conditions, such as diabetes, chronic heart disease, or chronic obstructive pulmonary disease about pneumococcal disease at the pharmacy.

Did you know that pharmacists are among the most accessible health care professionals? As pharmacists, you are well positioned and have notable training to engage in conversations with patients about pneumococcal disease.

By considering the 4 steps of: Identify, Initiate, Educate, and Recommend and Vaccinate, you can proactively speak with your patients about pneumococcal vaccination. Pharmacy vaccination laws and regulations vary by state. Consult the appropriate resources, including the relevant state pharmacy board, for more information.

Voice-Over:

Let’s discuss Indications and Select Safety Information for PNEUMOVAX 23. PNEUMOVAX 23 is a vaccine indicated for active immunization for the prevention of pneumococcal disease caused by the 23 serotypes contained in the vaccine. PNEUMOVAX 23 is approved for use in persons 50 years of age or older and persons aged 2 years and older who are at increased risk for pneumococcal disease. PNEUMOVAX 23 will not prevent disease caused by capsular types of pneumococcus other than those contained in the vaccine.

Now, let’s discuss some Select Safety Information for PNEUMOVAX 23, which you’ll hear more of throughout this video. Do not administer PNEUMOVAX 23 to individuals with a history of a hypersensitivity reaction to any component of the vaccine. Defer vaccination with PNEUMOVAX 23 in persons with moderate or severe acute illness. Use caution and appropriate care in administering PNEUMOVAX 23 to individuals with severely compromised cardiovascular and/or pulmonary function in whom a systemic reaction would pose a significant risk.

Dr. Cota:

Let’s take a closer look at these 4 steps in the pharmacy setting. At the pharmacy, you can identify a patient who is eligible for vaccination, based on their age, medical history, and by reviewing their medications to identify certain chronic conditions that are consistent with vaccination recommendations.

Since 1997, PNEUMOVAX 23 has been the only pneumococcal vaccine recommended by the CDC for immunocompetent adults under age 65 with diabetes, chronic heart disease, or chronic lung disease, such as COPD, at the time of diagnosis. Therefore, an adult patient picking up diabetes medication, heart disease medication, or an inhaler may signal that they have a chronic condition for which PNEUMOVAX 23 is recommended. Displaying educational materials may also help patients self-identify.

Voice-Over:

Here is some additional safety information for PNEUMOVAX 23. Available human data from clinical trials of PNEUMOVAX 23 in pregnancy have not established the presence or absence of a vaccine-associated risk.

Dr. Cota:

Once you identify a potentially appropriate patient, initiate a discussion to confirm eligibility for vaccination. This can be done by talking with the patient, reviewing their documentation, and excluding contraindications. Patients with a chronic condition like diabetes, chronic heart disease, or COPD may be receptive to discuss vaccination as part of a healthy lifestyle, or as part of their ongoing wellness program.

You can also help ensure that patients understand the potential serious consequences of disease and their personal risk. For example, patients with diabetes may also want to know that impaired glycemic control can put them at increased risk for pneumococcal infection. And patients with heart disease may want to know that the heart’s diminished capacity to pump blood causes lung congestion that can result in increased risk of pneumococcal infection. And patients with COPD may be interested to know that their condition contributes to chronic inflammation and reduced clearance of bacteria, thus increasing the risk for pneumococcal infection.

Voice-Over:

Let’s again discuss some safety information for PNEUMOVAX 23. Persons who are immunocompromised, including persons receiving immunosuppressive therapy, may have a diminished immune response to PNEUMOVAX 23. PNEUMOVAX 23 may not be effective in preventing pneumococcal meningitis in patients who have chronic cerebrospinal fluid, CSF, leakage resulting from congenital lesions, skull fractures, or neurosurgical procedures.

Dr. Cota:

Some patients may not know what vaccines are recommended for them. A recommendation from a health care provider is one of the most important factors in a patient’s decision to get vaccinated.

In a 2019 survey, only 1 in 5 pharmacists recommended or encouraged pneumococcal vaccination to eligible adults. This indicates a substantial opportunity for improvement. Phrases such as, “Pneumococcal disease can be serious,” “the CDC recommends you get this vaccine,” and “I strongly recommend that you get this vaccine” may resonate.

We know that time is limited; therefore, staff can also help with the vaccination process and aspects related to patient screening, inventory, and reviewing coverage. For patients who may be hesitant, learn why they have specific concerns. Additional follow-up can also be considered to help ensure they receive their recommended vaccinations.

Voice-Over:

Let’s take a moment to review more safety information for PNEUMOVAX 23. The most common adverse reactions, reported in more than 10% of subjects vaccinated with PNEUMOVAX 23 in clinical trials, were: injection-site pain/soreness/tenderness, injection-site swelling/induration, headache, injection-site erythema, asthenia and fatigue, and myalgia. Vaccination with PNEUMOVAX 23 may not offer 100% protection from pneumococcal infection.

Dr. Cota:

In summary, by considering the 4 steps of: Identify, Initiate, Educate, and Recommend & Vaccinate, you can help protect your adult patients under the age of 65 years with diabetes, chronic heart disease, or COPD from pneumococcal disease with PNEUMOVAX 23 at the pharmacy.

ref22

Reference

  1. American Pharmacists Association. Applying the Pharmacists’ Patient Care Process to Immunization Services. https://www.pharmacist.com/sites/default/files/Pharmacists%20Patient%20Care%20Process%20Module%20for%20Immunizations%20Services%20-%20FINAL.pdf. Accessed June 29, 2020.
ref23

Reference

  1. Immunization Action Coalition. Suggestions to improve your immunization services. https://www.immunize.org/catg.d/p2045.pdf. Accessed July 20, 2020.

Indication for PNEUMOVAX 23

PNEUMOVAX® 23 (Pneumococcal Vaccine Polyvalent) is a vaccine indicated for active immunization for the prevention of pneumococcal disease caused by the 23 serotypes contained in the vaccine (1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F, and 33F).

PNEUMOVAX 23 is approved for use in persons 50 years of age or older and persons aged ≥2 years who are at increased risk for pneumococcal disease.

PNEUMOVAX 23 will not prevent disease caused by capsular types of pneumococcus other than those contained in the vaccine.

Do not administer PNEUMOVAX 23 to individuals with a history of a hypersensitivity reaction to any component of the vaccine.
Defer vaccination with PNEUMOVAX 23 in persons with moderate or severe acute illness.

Do not administer PNEUMOVAX® 23 (Pneumococcal Vaccine Polyvalent) to individuals with a history of a hypersensitivity reaction to any component of the vaccine.

Defer vaccination with PNEUMOVAX 23 in persons with moderate or severe acute illness.

Use caution and appropriate care in administering PNEUMOVAX 23 to individuals with severely compromised cardiovascular and/or pulmonary function in whom a systemic reaction would pose a significant risk.

Available human data from clinical trials of PNEUMOVAX 23 in pregnancy have not established the presence or absence of a vaccine-associated risk.

Since elderly individuals may not tolerate medical interventions as well as younger individuals, a higher frequency and/or a greater severity of reactions in some older individuals cannot be ruled out.

Persons who are immunocompromised, including persons receiving immunosuppressive therapy, may have a diminished immune response to PNEUMOVAX 23.

PNEUMOVAX 23 may not be effective in preventing pneumococcal meningitis in patients who have chronic cerebrospinal fluid (CSF) leakage resulting from congenital lesions, skull fractures, or neurosurgical procedures.

The most common adverse reactions, reported in >10% of subjects vaccinated with PNEUMOVAX 23 in clinical trials, were: injection-site pain/soreness/tenderness, injection-site swelling/induration, headache, injection-site erythema, asthenia and fatigue, and myalgia.

For subjects aged 65 years or older in a clinical study, systemic adverse reactions which were determined by the investigator to be vaccine-related were higher following revaccination than following initial vaccination.

Vaccination with PNEUMOVAX 23 may not offer 100% protection from pneumococcal infection.

Before administering PNEUMOVAX 23, please read the accompanying Prescribing Information. The Patient Information also is available.

PNEUMOVAX® 23 (Pneumococcal Vaccine Polyvalent) is a vaccine indicated for active immunization for the prevention of pneumococcal disease caused by the 23 serotypes contained in the vaccine (1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F, and 33F).

PNEUMOVAX 23 is approved for use in persons 50 years of age or older and persons aged ≥2 years who are at increased risk for pneumococcal disease.

PNEUMOVAX 23 will not prevent disease caused by capsular types of pneumococcus other than those contained in the vaccine.


US-PNX-01116 08/20