June 14, 2021: Gonococcal Infection Treatment

Previous Question

A 52-year-old man with HIV is seen in clinic for a routine visit. He received his second dose of COVID-19 vaccine (Moderna product) 4 days ago with only a mild reaction and currently is asymptomatic. He is scheduled to get a dose of pneumococcal polysaccharide vaccine (PPSV-23) at this visit. What would you recommend regarding administering the PPSV-23 vaccine for this man?

Responses
A. He must wait at least 14 days after the most recent COVID-19 vaccine dose 40% (419)
B. He must wait at least 6 weeks after the most recent COVID-19 vaccine dose 6% (66)
C. He must wait at least 12 weeks after the most recent COVID-19 vaccine dose 3% (36)
D. He can receive the PPSV-23 vaccine at this clinic visit
51% (540)
  • A. He must wait at least 14 days after the most recent COVID-19 vaccine dose
  • B. He must wait at least 6 weeks after the most recent COVID-19 vaccine dose
  • C. He must wait at least 12 weeks after the most recent COVID-19 vaccine dose
  • D. He can receive the PPSV-23 vaccine at this clinic visit

Correct answer is D. Prior to May 14, 2021, the Centers for Disease Control and Prevention (CDC) recommended that no vaccines be coadministered within 14 days (before or after) any dose of the COVID-19 vaccine. These recommendations changed on May 14, 2021, and the CDC guidance now provides the following guidance (verbatim) regarding coadministering vaccines with COVID-19 vaccines:

  • COVID-19 vaccines and other vaccines may now be administered without regard to timing.
  • COVID-19 vaccines and other vaccines on the same day, as well as coadministration within 14 days.
  • If multiple vaccines are administered at a single visit, administer each injection in a different injection site.

This guidance does not mean that a practitioner cannot elect to defer a vaccine, which may be prudent in some situations, such as coadministering a dose of non-COVID-19 vaccine with the COVID-19 vaccine on the same day if the non-COVID-19 vaccine has a potent conjugate or adjuvant (eg, recombinant zoster vaccine or CPG-HepB) that may enhance the reactogenicity to the COVID-19 vaccine (or create highly uncomfortable/problematic combined postvaccine symptoms). Also, some practitioners may elect to delay the non-COVID-19 vaccine if it can easily be delayed and there is no eminent threat from that pathogen. In general, given the current state of the COVID-19 epidemic, the COVID-19 vaccine should always have priority for administration over a non-COVID-19 vaccine.

Click the Watch Webcast button to view “Vaccine Prevention for Individuals With HIV in the Era of COVID-19,” presented by David H. Spach, MD, at the May 20, 2021, virtual course, Unique Issues in HIV Prevention, Treatment, and Care in the COVID-19 World.