Pneumococcal Vaccination Schedule

Adults ≥65 Years: Primary Recommendations

The American College of Physicians recommends a single dose of PCV20 for adults ≥65 years who have never received pneumococcal vaccination, with no additional doses needed 1, 2, 3
For adults ≥65 years who have previously received PPSV23 only, a single dose of PCV20 is recommended at least 1 year after the last PPSV23 dose, completing the vaccination series 1, 2, 3
The Centers for Disease Control and Prevention (CDC) suggests that adults ≥65 years who have previously received PCV13 only should receive a single dose of PCV20 or PPSV23 at least 1 year after PCV13 1

The CDC recommends vaccination for adults 19-64 years with risk conditions such as chronic heart, liver, or lung disease, diabetes mellitus, cigarette smoking or alcoholism, cochlear implant or CSF leak, and immunocompromising conditions 3
For adults 19-64 years with risk conditions, a single dose of PCV20 is preferred, with an alternative option of PCV15 followed by PPSV23 1, 3

The CDC recommends shorter intervals of ≥8 weeks between PCV and PPSV23 for immunocompromised patients, reflecting greater urgency for protection in higher-risk patients 1, 3
For immunocompromised adults 19-64 years, a second PPSV23 dose is recommended ≥5 years after the first PPSV23 1

The CDC recommends a 4-dose series of PCV13 at ages 2, 4, 6, and 12-15 months for infants 2-6 months, with a primary series of 3 doses and a fourth booster dose at 12-15 months 4, 5, 6
For children 7-11 months, a 3-dose series is recommended, with the first 2 doses at least 4 weeks apart and the third dose at 12-15 months 4, 5, 7

The CDC recommends that PCV and PPSV23 should never be given on the same day, with minimum intervals of ≥1 year between PCV and PPSV23 for immunocompetent adults and ≥8 weeks for immunocompromised adults 1, 2, 3
For children <1 year, a minimum interval of 4 weeks is recommended between PCV doses, while children ≥1 year should have a minimum interval of 8 weeks between PCV doses 4

The CDC advises against giving multiple PPSV23 doses to adults ≥65 years who received PPSV23 at age ≥65, as only one dose is needed at this age 1
The CDC also recommends against using 5-year PPSV23 boosters for immunocompetent adults, as this only applies to select immunocompromised patients who received their first dose before age 65 1