Timing and Safety of Pneumococcal and Japanese Encephalitis Vaccines for Kids

How long should one wait to administer the pneumococcal vaccine (Prevnar) after receiving the Japanese encephalitis vaccine?

Hello Dr.
Hsiao,
1.
How long should I wait between administering the pneumococcal vaccine (Prevnar) and the Japanese encephalitis vaccine? My child (2 years and 10 months old) received the Japanese encephalitis vaccine just 2 days ago.
What side effects might occur? On April 9, I took my child to the health center for the Japanese encephalitis vaccine, and on April 11, during a pediatric check-up at another hospital, I inquired about the pneumococcal vaccine.
The doctor mentioned that the pneumococcal vaccine (7-valent) could be administered on the same day.
However, I just read in the FAQ section that one doctor responded: "According to the product instructions, administering Prevnar along with the free diphtheria, pertussis, and tetanus combination vaccine; the hexavalent vaccine; and the Japanese encephalitis vaccine together may result in increased side effects." Another response indicated that "the pneumococcal vaccine (Prevnar) has contraindications for combination with other vaccines: 1.
Whole-cell diphtheria, pertussis, and tetanus combination vaccine; 2.
Hexavalent vaccine (diphtheria, pertussis, tetanus, Haemophilus influenzae type b, hepatitis B, and inactivated polio vaccine); 3.
Japanese encephalitis vaccine."
2.
For a 2-year and 10-month-old child receiving the first dose (single dose) of the 7-valent pneumococcal vaccine, is it necessary to administer the 23-valent vaccine as well? If so, when would be the best time to do so? Thank you.
3.
Another child received the 23-valent pneumococcal vaccine at 3 and a half years old.
Should they also receive the 7-valent vaccine or a booster of the 23-valent vaccine? If so, when would be the best time for that? Thank you.

Danxin de mama, 30~39 year old female. Ask Date: 2009/04/14

Dr. Xiao Kaiwen reply Pediatrics

1.
Recently, according to the latest regulations from the Advisory Committee on Immunization Practices of the Ministry of Health in Taiwan, the Japanese encephalitis vaccine must be administered at least one month apart from the DTaP-Hib-IPV-HepB (pentavalent) vaccine.
However, it can be given simultaneously (at different injection sites) or with any interval from other vaccines, including the Prevnar (pneumococcal conjugate vaccine).
Therefore, administering the pneumococcal vaccine (Prevnar) and the Japanese encephalitis vaccine two days apart is theoretically acceptable.
2.
A child who received a single dose of the 7-valent pneumococcal vaccine at 2 years and 10 months does not need to receive the 23-valent vaccine, unless they belong to a high-risk group, such as those with immunocompromised conditions, congenital heart disease, cancer, or asplenia, although this is still under consideration.
3.
The 23-valent pneumococcal vaccine has a poorer immunological memory; therefore, some experts recommend administering an additional dose of the 7-valent pneumococcal vaccine, with intervals suggested to be either 2 months or 6 months.
However, if an additional dose of the 7-valent pneumococcal vaccine is to be given, it is recommended to administer two doses (2 months apart) to enhance immunological memory.
Please discuss this with your physician.

Reply Date: 2009/04/14

More Info

When it comes to the timing and safety of pneumococcal (PCV) and Japanese encephalitis (JE) vaccines for children, there are several important considerations to keep in mind.
Firstly, regarding the timing of the pneumococcal vaccine (specifically the 7-valent PCV) and the Japanese encephalitis vaccine, current guidelines indicate that these vaccines can be administered simultaneously or with minimal intervals between them. The Centers for Disease Control and Prevention (CDC) and other health authorities recommend that vaccines can be given on the same day as long as they are administered in different injection sites. In your case, since your child received the Japanese encephalitis vaccine on April 9 and the pneumococcal vaccine two days later on April 11, this is generally acceptable.
As for potential side effects, it is important to note that both vaccines are well-studied and have established safety profiles. Common side effects may include mild fever, soreness at the injection site, or irritability. Serious side effects are rare. However, if your child experiences any unusual symptoms or severe reactions, it is advisable to consult a pediatrician for further evaluation.

Now, addressing your second question about the necessity of the 23-valent pneumococcal vaccine (PPSV23) after receiving the 7-valent vaccine, the general recommendation is that children who are at higher risk for pneumococcal disease may require the PPSV23 vaccine. For a healthy child who has received the 7-valent vaccine at 2 years and 10 months, additional doses of the 23-valent vaccine are typically not necessary unless there are specific risk factors such as immunocompromised conditions, chronic diseases, or other high-risk factors. If your child is healthy, the 7-valent vaccine should provide adequate protection.

Regarding your third question about a child who received the 23-valent vaccine at 3.5 years of age, the recommendations can vary based on individual health status. If that child is otherwise healthy, there may not be a need for additional doses of either the 7-valent or the 23-valent vaccine. However, if the child has specific health concerns or risk factors, it would be prudent to discuss with a healthcare provider whether additional vaccination is warranted.

In summary, the administration of the pneumococcal and Japanese encephalitis vaccines can be done safely with minimal intervals, and the need for additional doses of the pneumococcal vaccine depends on the child's health status and risk factors. Always consult with a healthcare provider for personalized medical advice tailored to your child's specific situation. Vaccination is a critical component of preventive healthcare, and staying informed about the recommended schedules and safety measures is essential for ensuring the health and well-being of children.

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