<p><strong>Persons with Moderate or Severe Acute Illness</strong>: Defer vaccination with Pneumococcal Vaccine in persons with moderate or severe acute illness.<br />
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<strong>Persons with Severely Compromised Cardiovascular or Pulmonary Function</strong>: Caution and appropriate care should be exercised in administering Pneumococcal Vaccine to individuals with severely compromised cardiovascular and/or pulmonary function in whom a systemic reaction would pose a significant risk.<br />
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<strong>Use of Antibiotic Prophylaxis</strong>: This vaccine does not replace the need for penicillin (or another antibiotic) prophylaxis against pneumococcal infection. In patients who require penicillin (or another antibiotic) prophylaxis against pneumococcal infection, such prophylaxis should not be discontinued after vaccination with Pneumococcal Vaccine.<br />
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<strong>Persons with Altered Immunocompetence</strong>: Persons who are immunocompromised, including persons receiving immunosuppressive therapy, may have a diminished immune response to Pneumococcal Vaccine.<br />
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<strong>Persons with Chronic Cerebrospinal Fluid Leakage</strong>: Pneumococcal Vaccine&nbsp;may not be effective in preventing pneumococcal meningitis in patients who have chronic cerebrospinal fluid (CSF) leakage resulting from congenital lesions, skull fractures, or neurosurgical procedures.</p>