Pneumococcal Vaccination Schedule for Adults

General Recommendations

The Centers for Disease Control and Prevention (CDC) recommends a single dose of PCV20 for all adults aged 65 years and older, as well as adults 19-64 years with risk conditions who have not previously received a pneumococcal conjugate vaccine 1, 2
For adults ≥65 years who have never received a pneumococcal vaccine or received only PCV7, the CDC recommends administering a single dose of PCV20 2
For adults ≥65 years who previously received PPSV23 only, the CDC recommends administering a single dose of PCV20 after a ≥1 year interval since the last PPSV23 dose 2
For adults 19-64 years with chronic medical conditions, the CDC recommends administering a single dose of PCV20 for those who have never received a pneumococcal vaccine or received only PCV7 3

For adults with hematopoietic stem cell transplant (HSCT) who have received no pneumococcal vaccines after HSCT, the CDC recommends administering 3 doses of PCV20, 4 weeks apart starting 3–6 months after HSCT, followed by a fourth PCV20 dose ≥6 months after the third dose or ≥12 months after HSCT, whichever is later 1, 6
For adults with immunocompromising conditions, the CDC recommends administering a single dose of PCV20 for those who have never received a pneumococcal vaccine 4

If PCV20 is not available, the CDC recommends using PCV15 followed by PPSV23, with the specific schedule depending on the patient's age and health status 2, 3

The CDC prioritizes the use of PCV20 as a single dose for most adults, simplifying the vaccination schedule compared to previous recommendations 1, 2
For patients who have already received PCV13 and PPSV23 at age ≥65 years, providers may choose to administer PCV20 after a ≥5 year interval since the last pneumococcal vaccine dose 2
Not waiting the appropriate interval between different pneumococcal vaccines can reduce immune response 1, 2
The vaccination schedule differs for immunocompromised patients compared to those with chronic medical conditions 3, 4