Pneumococcal Disease According to F883, Immunizations for pneumococcal pneumonia the requirements have five aspects: The resident is provided education regarding the benefits and potential side effects of the vaccination The facility must offer each resident pneumococcal immunizations unless the immunization is medically contraindicated, ore the resident’s immunization status is current The resident, or resident’s legal representative, has the right to refuse the vaccinations Each eligible resident is administered the pneumococcal vaccine (unless refused or contraindicated or the resident has already been immunized) The facility must document that education was provided and that the resident either received the vaccine or, if not received, that the vaccine was refused or medically contraindicated or the resident had already been immunized Make sure your facility policy includes all five requirements and that the resident’s medical record documents patient education, offering the vaccine, administering the vaccine. Two pneumococcal vaccines are recommended for adults: PCV13, Prevnar13 and PPSV23, Pneumovax 23. One dose of PCV13 is recommended for adults 65 years and older who have not previously received PCV13. For patients who have not received any pneumococcal vaccine or with unknown vaccination history, give 1 dose of PCV13, and administer 1 dose of PPSV23 at least 1 year later. Once a dose of PPSV23 is given at age 65 or older, no additional doses of PPSV23 should be
F 883 Guidance to Surveyors 483.80(d) Influenza and pneumococcal immunizations The intent of this regulation is to: Minimize the risk o resident acquiring, transmitting, or experiencing complications from influenza an pneumococcal disease by ensuring that each resident: Is informed about the benefits and risks of immunizations: and Has the opportunity to receive the influenza and pneumococcal vaccine(s), unless medically contraindicated, refused or was already immunized Ensure documentation in the resident’s medical record of the information/education provided regarding the benefits and risks of immunization and the administration or the refusal of or medical contraindications to the vaccine(s). Please see the Flu Vaccine Toolkit and Pneumococcal Disease Toolkit for forms and resources.
Question: Is there a difference between pneumococcal vaccines? Answer: Since 2005, Centers for Medicare and Medicaid Services required nursing home to ensure that their residents receive pneumococcal vaccinations. Facilities must offer pneumococcal bacteria: Prevnar, Prevnar13(PCV13), Synflorix and Pneumovax23(PPSV23). There are differences in the way that they are made. Prevnar, Prevnar 13 and Synflorix are conjugate vaccines, while Pneumovax23 is polysaccharide vaccines. Prevnar offers protection against 7 common strains of pneumococcal bacteria, Synflroix against 10 types, Prevnar13 against 13 types and Pneumovax23 against 23 strains of the bacteria. According to recent guidelines, the Advisory Committee in Immunization Practices (ACIP) recommends sequential administration of 2 pneumococcal vaccines for adults over 65 years of age. CMS guidelines recommends the administration of Prevnar 13 followed by Pneumovax23 6 to 12 months later. Those in the 19 to 64 age group are still recommended to receive one dose of Pneumova23 every 5 years. The decision is based on age group and if the patient has been vaccinated previously.