Primary vaccination:
. Adults and children of 2 years of age or older: one single dose of 0.5 milliliter by intramuscular or subcutaneous injection. Prenovax 23 vaccine is not recommended for use in
children below 2 years of age as the safety and efficacy of the vaccine have not been established and the antibody response may be poor.

Special dosing:
. It is recommended that pneumococcal vaccine should preferably be given at least two weeks before elective splenectomy or the initiation of chemotherapy or other
immunosuppressive treatment. Vaccination during chemotherapy or radiation therapy should be avoided.
. Following completion of chemotherapy and/or radiation therapy for neoplastic disease, immune responses to vaccination may remain diminished. The vaccine should not be
administered any sooner than three months after completion of such therapy. A longer delay may be appropriate for patients who have received intensive or prolonged treatment.
. Persons with asymptomatic or symptomatic HIV infection should be vaccinated as soon as possible after their diagnosis is confirmed.

Revaccination:
. One single dose of 0.5 milliliter by intramuscular or subcutaneous injection.
. The specific timing of, and need for, revaccination should be determined on the basis of available official recommendations.
. Revaccination at an interval of less than three years is not recommended because of an increased risk of adverse reactions. The rates of local and, in persons aged ≥65 years,
some systemic reactions have been shown to be higher after revaccination than after primary vaccination when three to five years have elapsed between doses.

Adults: Healthy adults should not be revaccinated routinely. Revaccination may be considered for persons at increased risk of serious pneumococcal infection who were given
pneumococcal vaccine more than five years earlier or for those known to have a rapid decline in pneumococcal antibody levels. For selected populations (e.g., asplenics) who are known
to be at high risk of fatal pneumococcal infections, revaccination at three years may be considered.

Children: Healthy children should not be revaccinated routinely.

Children of 10 years of age and over: May be considered for revaccination according to the adult recommendation.