Suggested criteria for full Haemophilus influenza type b and Streptococcus pneumoniae immunization status when considering empiric antibiotics for community-acquired pneumonia in children

Hib: H. influenzae type b; PCV: pneumococcal conjugate vaccine.
* Children younger than 12 months are incompletely immunized against Hib and S. pneumoniae.
¶ Immunizations must be completed at least two weeks before pneumonia diagnosis.
Δ Children at high risk for invasive Hib disease include chemotherapy recipients and those with anatomic or functional asplenia (including sickle cell disease), HIV infection, immunoglobulin deficiency, or early component complement deficiency. Please refer to the UpToDate topic on prevention of H. influenzae infection for a discussion of full Hib immunization in children at high risk for invasive Hib disease.
◊ Children at high risk for invasive S. pneumoniae disease include those with chronic heart disease (particularly cyanotic congenital heart disease and cardiac failure); chronic lung disease (including asthma if treated with high-dose oral corticosteroid therapy); diabetes mellitus; cerebrospinal fluid leak; cochlear implant; sickle cell disease and other hemoglobinopathies; anatomic or functional asplenia; HIV infection; chronic renal failure; nephrotic syndrome; diseases associated with treatment with immunosuppressive drugs or radiation therapy, including malignant neoplasms, leukemias, lymphomas, and Hodgkin disease; solid organ transplantation; or congenital immunodeficiency. Please refer to the UpToDate topics on PCVs and pneumococcal polysaccharide vaccines for a discussion of full S. pneumoniae immunization in children at high risk for invasive S. pneumoniae disease.