Do not inj IV or intradermally. Ensure at least 2 wk interval between Pneumovax 23 administration & initiation of immunosuppressive therapy (eg, patients w/ Hodgkin's disease or undergoing organ or bone marrow transplantation), & before elective splenectomy. Avoid vaccination during chemotherapy or radiation therapy. Concomitant use w/ Zostavax. Revaccination of immunocompetent patients previously vaccinated w/ 23-valent polysaccharide vaccine is not recommended except for patients ≥2 yr at highest risk of serious pneumococcal infection & have rapid decline in pneumococcal antibody levels, provided at least 5 yr passed since initial dose of pneumococcal vaccine; consider revaccination 3 yr after previous dose in childn ≤10 yr & at highest risk of severe pneumococcal infection; high risk group includes persons w/ functional or anatomic asplenia, HIV infection, leukemia, lymphoma, Hodgkin's disease, multiple myeloma, generalized malignancy, chronic renal failure, nephrotic syndrome, or other conditions associated w/ immunosuppression & receiving immunosuppressive chemotherapy. Severely compromised CV &/or pulmonary function in whom a systemic reaction would pose a significant risk. Delay use for any febrile resp illness or other active infection (except when withholding Pneumovax 23 entails even greater risk). In patients who require penicillin (or other antibiotic) prophylaxis against pneumococcal infection, such prophylaxis should not be discontinued after vaccination w/ Pneumovax 23. Pregnancy & lactation. Childn <2 yr. Elderly.