possible.onasemnogene abeparvovecMonitor Closely (1)onasemnogene abeparvovec decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Adjust vaccinations to accommodate concomitant corticosteroid administration prior to and following onasemnogene abeparvovec infusion. When initiating systemic corticosteriod therapy, wait 2 weeks after an inactivated vaccine.oxaliplatinMonitor Closely (1)oxaliplatin decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .ozanimodMinor (1)ozanimod decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Minor/Significance Unknown. No clinical data are available on the efficacy and safety of vaccinations in patients taking ozanimod. Vaccinations may be less effective if coadministered with ozanimod.prednisoloneSerious - Use Alternative (1)prednisolone decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.prednisoneSerious - Use Alternative (1)prednisone decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.procarbazineMonitor Closely (1)procarbazine decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .rilonaceptSerious - Use Alternative (1)rilonacept decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.satralizumabMonitor Closely (1)satralizumab decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines. At least 2 weeks before initiating for non-live vaccines. .secukinumabSerious - Use Alternative (1)secukinumab decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.siponimodSerious - Use Alternative (1)siponimod decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Pause vaccinations beginning 1 week before initiating siponimod and for 4 weeks after stopping treatment. Coadministration with live attenuated vaccines may increase infection risk.sirolimusSerious - Use Alternative (1)sirolimus decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.tacrolimusSerious - Use Alternative (1)tacrolimus decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.temsirolimusSerious - Use Alternative (1)temsirolimus decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.teplizumabSerious - Use Alternative (1)teplizumab decreases effects of pneumococcal vaccine polyvalent by Other (see comment). Avoid or Use Alternate Drug. Comment: Administer all age-appropriate vaccinations before starting teplizumab. Inactivated or mRNA vaccines are not recommended within 2 weeks before teplizumab treatment, during treatment, or 6 weeks after completion of treatment.tralokinumabMonitor Closely (1)tralokinumab will decrease the level or effect of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Use Caution/Monitor. Limited data are available regarding coadministration with non-live vaccines.triamcinolone acetonide injectable suspensionSerious - Use Alternative (1)triamcinolone acetonide injectable suspension decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.ublituximabMonitor Closely (1)ublituximab decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.ustekinumabMonitor Closely (1)ustekinumab decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Use Caution/Monitor. Inactivated vaccinations administered during ustekinumab treatment may not elicit an immune response sufficient to prevent disease.voclosporinMonitor Closely (1)voclosporin decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.zoster vaccine liveContraindicated (1)pneumococcal vaccine polyvalent decreases effects of zoster vaccine live by Other (see comment). Contraindicated. Comment: Reduced immune response to zoster vaccine live as measured by gpELISA when coadministered with pneumococcal vaccine polyvalent compared with those who received the vaccines 4 weeks apart.zoster vaccine recombinantMonitor Closely (1)pneumococcal vaccine polyvalent decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce the effectiveness of zoster vaccine recombinant. Suspected adverse events after administration of any vaccine may be reported to Vaccine Adverse Events Reporting System (VAERS), 1-800-822-7967 Frequency Not Defined Erythema, induration, soreness at inj site Low grade fever Rash N/V Lymphadenitis ITP relapse Hemolytic anemia Thrombocytopenia Anaphylactoid reaction Angioedema Serum sickness due to drug Guillain-Barre syndrome Contraindications Previous vaccination with pneumococcal vaccine, within 10 days of immunosuppressive therapy Cautions Polysaccharide capsular vaccine against 23 strains of pneumococci (90% of blood isolates & 85% of isolates found in sterile sites) CDC now recommends second dose after 5 years for pts with chronic renal failure, asplenia, HIV infection, cancer, or other conditions associated w/immunosuppression Splenectomy: administer at least 2 wk before scheduled procedure Defer vaccination in persons with moderate or severe acute illness Exercise caution and appropriate care in individuals with severely compromised cardiovascular and/or pulmonary function in whom a systemic reaction would pose significant risk This vaccine does not replace the need for penicillin (or other antibiotic) prophylaxis against pneumococcal infection. In patients who require penicillin (or other antibiotic) prophylaxis against3 Vaccine does not replace need for penicillin (or other antibiotic) prophylaxis against pneumococcal infection; in patients who require penicillin (or other antibiotic) prophylaxis against neumococcal infection, such prophylaxis should not be discontinued after vaccination Persons who are immunocompromised, including persons receiving immunosuppressive therapy, may have a diminished immune response to vaccine Vaccine 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 Pregnancy Human data from clinical trials in pregnancy have not been established the presence or absence of a vaccine-associated risk Developmental toxicity studies have not been conducted in animals Lactation Unknown if excreted in human milkPregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action S. pneumoniae capsular antigens stimulate active immune response resulting in production of endogenously produced antibodies The 23 serotypes contained in the vaccine include: 1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F, and 33F Instructions For IM or SC administration Inject into the deltoid muscle or lateral mid-thigh BRAND FORM. UNIT PRICE PILL IMAGE Pneumovax-23 injection- 25 mcg/0.5 mL solutionPneumovax-23 injection- 25 mcg/0.5 mL solutionPneumovax-23 injection- 25 mcg/0.5 mL vialCopyright © 2010 First DataBank, Inc.Print Patient Educationpneumococcal 23 polyvalent vaccine injection PNEUMOCOCCAL POLYSACCHARIDE VACCINE - INJECTION (NEU-mo-KOK-al paa-lee-SA-kr-ide) COMMON BRAND NAME(S): Pneumovax 23, Pnu-Imune 23 USES: This vaccine helps protect against serious infection (such as meningitis, bacteria in the blood) due to certain bacteria (Streptococcus pneumoniae). This vaccine is important for preventing infection in individuals at risk (such as those with heart disease, lung disease, liver disease, diabetes, alcoholism, spleen problems, sickle cell anemia, or HIV, or those living in a nursing home). HOW TO USE: Read all vaccine information available from your health care professional before receiving the vaccine. If you have any questions, ask your health care professional.This vaccine is injected into a muscle or under the skin by a health care professional. When this vaccine is injected into a muscle, it is given in the upper arm or thigh.You may need to have another dose of vaccine if you are still at high risk for infection. This is especially true if you are younger than 65 years old when you receive the first dose of this vaccine. A second dose should not be given until 5 years after your first dose. Ask your health care professional for more details.If you are receiving this vaccination before spleen surgery or before receiving cancer chemotherapy or other drugs that decrease your immune system function, it should be given at least 2 weeks before these procedures to be effective. Talk to your health care professional for more information. SIDE EFFECTS: Injection site reactions (such as pain, redness, swelling, hard lump), muscle/joint aches, or fever may occur. Ask your health care professional whether you should take a fever/pain reducer (such as acetaminophen) to help treat these symptoms. Nausea and vomiting may also occur. If any of these effects last or get worse, tell your health care professional promptly.Rarely, some people have symptoms such as fainting, dizziness, vision changes, or ringing in the ears just after getting a vaccine injection. Tell your health care professional right away if you have any of these symptoms. Sitting or lying down may help, since these symptoms usually don't last long.Remember that this medication has been prescribed because your health care professional has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your health care professional right away if you have any serious side effects, including: unusual weakness, tingling/numbness of the hands/feet, swollen glands.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice any other effects not listed, contact your health care professional.Contact the health care professional for medical advice about side effects. The following numbers do not provide medical advice, but in the US you may report side effects to the Vaccine Adverse Event Reporting System (VAERS) at 1-800-822-7967. In Canada, you may call the Vaccine Safety Section at Public Health Agency of Canada at 1-866-844-0018. PRECAUTIONS: Before you receive this vaccine, tell the health care professional if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as the preservative phenol, latex or dry natural rubber in the vial stopper), which can cause allergic reactions or other problems. Talk to your health care professional for more details.Before using this vaccine, tell your health care professional your medical history, especially of: your vaccination/immunization history, recent illness/fever, immune system disorders (such as due to HIV infection, certain cancers such as leukemia/lymphoma, cancer or radiation treatment).This vaccine is not recommended for use in children younger than 2 years.During pregnancy, this vaccine should be used only when clearly needed. Discuss the risks and benefits with your health care professional.It is unknown if this vaccine passes into breast milk. Consult your health care professional before breast-feeding. DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your health care professional. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this vaccine include: drugs that weaken the immune system (including cyclosporine, tacrolimus, cancer chemotherapy, corticosteroids such as prednisone).