Pneumococcal Vaccine Recommendations for Adults

Current Recommendations Based on Age and Risk Factors

The Centers for Disease Control and Prevention (CDC) recommends a single dose of PCV20 as the preferred option for pneumococcal vaccination for all adults aged ≥65 years and adults 19-64 years with risk conditions who have not previously received a pneumococcal conjugate vaccine 1
For adults ≥65 years, the primary recommendation is a single dose of PCV20 2, 1
For adults ≥65 years who previously received PPSV23 only, administer a single dose of PCV20 after a ≥1 year interval since the last PPSV23 dose 2, 1
For adults 19-64 years with risk conditions, the primary recommendation is a single dose of PCV20 2, 1
Risk conditions warranting vaccination at ages 19-64 include chronic heart, liver, or lung disease, diabetes mellitus, cigarette smoking, alcoholism, cochlear implant or CSF leak, and immunocompromising conditions 3, 4

For adults with specified immunocompromising conditions who received PCV13 only, administer PPSV23 after ≥8 weeks, then a second PPSV23 dose ≥5 years after the first PPSV23 dose 2
Hematopoietic stem cell transplant recipients are recommended to receive 4 doses of PCV20, starting 3-6 months after HSCT 2, 1

Adults with immunocompromising conditions, CSF leak, or cochlear implant might benefit from shorter intervals (≥8 weeks) between PCV15 and PPSV23 3
Not waiting the appropriate interval between different pneumococcal vaccines can reduce immune response 1

Failing to identify adults aged 19-64 years with risk conditions who should receive pneumococcal vaccination 3
Administering pneumococcal vaccines without respecting the recommended intervals between doses 1
Not recognizing that vaccination schedules differ for immunocompromised patients compared to those with chronic medical conditions 2, 1
Overlooking the need for pneumococcal vaccination in adults with asthma, which is now recognized as a risk factor 3
Missing opportunities to vaccinate adults with diabetes, who have 1.4-5.9 times the risk for invasive pneumococcal disease compared to those without risk conditions 3