Do not vaccinate via IV route or by gluteal IM inj, & ensure syringe needle is not puncturing blood vessels during inj. Postpone vaccination in case of fever, acute diseases, & acute attack of chronic diseases. Appropriate monitoring & medical care & rescue measures should be readily available in case of occurrence of rare hypersensitivity reactions during vaccination. Patients w/ thrombocytopenia, any coagulopathy or those who are receiving anticoagulant treatment. Immunocompromised individuals (eg, malignancy or nephrotic syndrome). Tetanus toxoid contained in the vaccine is not a replacement for routine immunization of tetanus vaccine or tetanus-containing vaccine. Not guaranteed that all recipients can be protected from any diseases caused by
Strep pneumoniae. Pregnancy & lactation. Monitor preterm infants for potential risk of apnea during primary series. Consider at least 48 hr of monitoring for preterm infants under hospitalization (gestational age ≤30 wk at birth) vaccinated w/ PCV13-TT according to recommended immunization schedule. Not a replacement of 23-valent pneumococcal polysaccharide vaccine in childn ≥24 mth w/ conditions eg, sickle cell disease, asplenia, HIV infection, chronic illness, or those who are immunocompromised.