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PCV13, PPSV23 vaccine are stimulates mucosal immunity, thereby preventing nasal colonization of Streptococcus pneumoniae. Mucosal immunity leads to two population-level effects: indirect herd immunity and emergence of replacement strains. With widespread use of PCV in infants and children, pneumococcal transmission decreases and thus lends protection to unvaccinated individuals including adults.As a result, with the exception of serotypes against which the vaccines are not effective, serotypes present in and then in PCV13 have nearly disappeared from the pediatric and adult populations.However, as these serotypes disappear, new pneumococcal serotypes emerge to occupy the vacant ecologic niche; these are called “replacement strains.” These concepts are discussed in further detail elsewhere in the topic. APPROACH TO VACCINATION The United States Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices ACIP updated its recommendation in 2022.The approach of the authors of this topic is largely consistent with the ACIP although varies for certain patient populations. These recommendations are discussed in the sections that follow. Indications for vaccination, The goal of vaccination in adults is to prevent invasive pneumococcal disease IPD; eg, bacteremic pneumonia, meningitis and nonbacteremic pneumonia.In agreement with the ACIP.,we recommend pneumococcal vaccination for, All adults 65 years of age Adults aged 19 to 64 years. Predisposing chronic medical conditions, eg, chronic lung disease, chronic liver disease,diabetes mellitus,Increased risk of meningitis,eg, cochlear implant, cerebrospinal fluid.Immunocompromising conditions eg, human immunodeficiency virus HIV infection, hematologic malignanciesand other conditions associated with altered immunocompetence functional or anatomic asplenia, chronic renal disease, and nephrotic syndrome Functional or anatomic asplenia.In addition to the indications outlined by the ACIP, we also recommend pneumococcal vaccination for those with prior history of IPD. In situations where it is unclear whether pneumococcal vaccination is indicated or not, we choose to vaccinate because the benefits of the vaccine outweigh the minimal risks.These populations are at increased risk of developing IPD and/or are at higher risk of morbidity and mortality from IPD.In 2018, approximately 43 percent of IPD occurred in those over the age of 65 and another 48 percent in adults 65 years of age with predisposing conditions.While there is evidence that many patients with immunocompromising conditions such as lymphoma or multiple myeloma are unlikely to develop antibody following vaccination with pneumococcal conjugate vaccines or pneumococcal polysaccharide vaccine the potential benefits of even suboptimal responses greatly outweigh the risks and the cost is regarded as appropriate for the benefit received. Vaccination is not recommended for healthy adults less than 65 years of age. Although the risk for pneumococcal disease starts to increase at age 50 analyses have suggested initiating vaccination at that age would not be cost-effective; thus, the ACIP did not lower the recommended age for vaccination in healthy adults.Approach to healthy older adults and those with predisposing medical conditions — The ACIP recommends the 20-valent PCV alone or the 15-valent PCV PCV13 by the 23-valent PPSV PPSV23for all adults with indications for vaccination For most adults.when available, due to the simplicity and lower cost of a single-dose vaccine. Comparative efficacy of these two approaches is unknown. If PCV13 is followed by PPSV23 is a recommended alternative. If PCV13 is administered, PPSV23 should be administered one year after PCV13 to provide immunity against an increased number of pneumococcal serotypes.When the series PCV13 followed by PPSV23 is completed, protection is offered to an additional three serotypes. Hi,This is vaccine for Bangladesh just for vaccine channel, here share vaccine related information.Vaccine for Bangladesh is give very best service into people’s.plz share my video.#vaccineforbangladesh #vaccine #rabies #bangladesh #like #prevention is better than cure.#vaccineforbangladesh #vaccine #rabies #bangladesh #influenzavaccine #pneumoniavaccine #epivaccine #papilovax #rabixvc #vaxphoid #vaxitet #vaxitetig #prenovax23 #evimar13 #chickenpox #vericellavaccine #cervarix #gurdasil #rotarix #cholera #mmr #mr #vaxigrif #sinflorix #vericella vaccine #vaccine for all type #papillomavirus #influvaxtetra #toxic #virus #bacteria #microbes #rotavirus #AIDs #HPV #HIV #rabiesimmunoglobulin #hepatitis a #hepatitis b #zoster virus #gram positive #gram negative#pcv#opv#tt vaccine #Hib #dpt #conjugated #polysaccharide #টিকা#টিটেনাস #জরায়ুমুখ ক্যান্সার টিকা#কলেরা#টাইফয়েড #জলাতঙ্ক প্রতিরোধী টিকা#জলাতঙ্ক #হেপাটাইটিস বি#হেপাটাইটিস এ #ভাইরাস #ব্যাকটেরিয়া#প্রতিরোধী