Vaccine Intervals for Japanese Encephalitis and Pneumococcal Vaccines in Pediatrics

Regarding the interval issue between Japanese encephalitis and pneumococcal pneumonia?

Hello: I am looking for information on vaccine intervals from common pediatric vaccination questions.
On October 20, 2008, a mother asked about vaccine intervals, and the doctor responded that the Japanese Encephalitis vaccine and the Pneumococcal vaccine should be spaced one month apart.
I would like to confirm with the doctor whether this is indeed the case.
I previously read that live vaccines can be administered simultaneously, but if not given at the same time, they should be spaced one month apart.
Since both the Japanese Encephalitis and Pneumococcal vaccines are inactivated, should they also be spaced one month apart if not given simultaneously? I have already administered the second dose of the Japanese Encephalitis vaccine and originally planned to give the second dose of the Pneumococcal vaccine two weeks later.
Since my child received the first dose of the Pneumococcal vaccine at one year and two months, the second dose is due two months later.
If that is the case, should I change it to one month later for the second dose of the Pneumococcal vaccine? After completing the second dose of the Pneumococcal vaccine, how long should I wait before administering the Varicella vaccine? My child is currently one year and three months old.

Tang Gu Ma, 30~39 year old female. Ask Date: 2009/07/21

Dr. Xiao Kaiwen reply Pediatrics

The initial recommendation from the manufacturer was to space the administration of the pneumococcal vaccine and the Japanese encephalitis vaccine by one month.
However, the Advisory Committee on Immunization Practices of the Department of Health has since removed this requirement (live vaccines can be administered simultaneously; if not given together, they should be spaced one month apart; inactivated vaccines can be given simultaneously or spaced at any interval, except for the Japanese encephalitis vaccine and vaccines containing pertussis, which should be spaced one month apart; inactivated and live vaccines can also be administered simultaneously or spaced at any interval).
Therefore, it is acceptable for your child to receive the second dose of the pneumococcal vaccine two weeks after the second dose of the Japanese encephalitis vaccine.
After receiving the second dose of the pneumococcal vaccine, the varicella vaccine can be administered at any time (clinically, we often recommend spacing it by 1 to 2 weeks).

Reply Date: 2009/07/21

More Info

When it comes to pediatric vaccinations, understanding the recommended intervals between different vaccines is crucial for ensuring the safety and efficacy of immunization schedules. In your inquiry regarding the intervals between the Japanese Encephalitis (JE) vaccine and the Pneumococcal vaccine, it is important to clarify a few key points based on current medical guidelines.

Firstly, the Japanese Encephalitis vaccine is typically administered in a two-dose series, with the second dose given at least one month after the first dose. The Pneumococcal vaccine, particularly the 13-valent pneumococcal conjugate vaccine (PCV13), is also given in a series, with doses spaced out according to the child’s age at the time of the first dose. For children who receive their first dose of PCV13 before 24 months of age, the second dose is usually given 2 months after the first dose.

The confusion often arises from the distinction between live attenuated vaccines and inactivated vaccines. Live vaccines, such as the measles, mumps, and rubella (MMR) vaccine, can sometimes be administered simultaneously or spaced out by a minimum of 28 days. In contrast, inactivated vaccines, like the JE and Pneumococcal vaccines, do not have the same restrictions and can generally be administered at the same time or with shorter intervals between doses.

According to the latest guidelines from health authorities, the JE vaccine and the Pneumococcal vaccine can be administered simultaneously, provided they are given in different injection sites. If they are not given at the same time, there is no strict requirement to wait one month between the two. Therefore, if your child has already received the second dose of the JE vaccine, you can proceed with the second dose of the Pneumococcal vaccine without needing to wait an additional month.

Regarding your specific situation, since your child has received the second dose of the JE vaccine and is due for the second dose of the Pneumococcal vaccine, you can schedule the Pneumococcal vaccine as planned, ideally within the recommended timeframe of 2 months after the first dose. After administering the second dose of the Pneumococcal vaccine, you can then consider the timing for the Varicella (chickenpox) vaccine. The Varicella vaccine is typically given at 12-15 months of age, with a second dose recommended between 4-6 years of age. Therefore, if your child is currently 1 year and 3 months old, you can administer the Varicella vaccine shortly after the Pneumococcal vaccine, as there are no contraindications for administering these vaccines in close succession.

In summary, it is safe to administer the Pneumococcal vaccine shortly after the JE vaccine, and you do not need to wait a full month if they are given at different sites. Always consult with your pediatrician or healthcare provider to ensure that your child's vaccination schedule is tailored to their specific health needs and local guidelines. Keeping an open line of communication with your healthcare provider will help you navigate the complexities of vaccination schedules and ensure your child remains protected against preventable diseases.

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