Pneumococcal Vaccine Recommendations

General Recommendations

• The Centers for Disease Control and Prevention recommends PPSV23 for all adults aged ≥65 years, regardless of previous vaccination history or medical conditions 3, 4
• The Centers for Disease Control and Prevention recommends shared clinical decision-making for PCV13 in adults ≥65 years without immunocompromising conditions, CSF leaks, or cochlear implants 1, 5
• Adults who received PPSV23 before age 65 should receive one additional dose of PPSV23 at age ≥65 years, at least 5 years after the previous dose 4, 6

Specific Indications by Medical Condition

• The Centers for Disease Control and Prevention recommends PCV13 followed by PPSV23 for adults with immunocompromising conditions, such as congenital or acquired asplenia, sickle cell disease, chronic renal failure, and HIV infection 1, 3, 4, 5
• The Centers for Disease Control and Prevention recommends PCV13 followed by PPSV23 for adults with CSF leaks or cochlear implants 1, 4

Timing and Administration Considerations

• The Centers for Disease Control and Prevention recommends that PCV13 and PPSV23 should not be coadministered 4
• For adults with immunocompromising conditions, CSF leaks, or cochlear implants, the Centers for Disease Control and Prevention recommends giving PCV13 first, then PPSV23 ≥8 weeks later 4

Important Considerations

• The recommendation for PCV13 changed in 2019 due to reduced incidence of PCV13-type disease through indirect effects from pediatric vaccination 3, 7
• PPSV23 contains 11 additional serotypes not in PCV13, which account for 32-37% of invasive pneumococcal disease among adults ≥65 years 4, 6