Pneumococcal Vaccine Indications

Indications by Age Group

The Centers for Disease Control and Prevention recommends pneumococcal vaccination for all adults aged ≥65 years and for persons aged 2-64 years with specific risk factors, including chronic illnesses, immunocompromising conditions, anatomic or functional asplenia, and certain environmental or social settings that increase risk of pneumococcal disease 1, 2
Adults aged 65 years and older should receive pneumococcal vaccination regardless of previous vaccination history or health status, with either a single dose of PCV20 alone or a dose of PCV15 followed by PPSV23 at least 1 year later 1, 2
For adults ≥65 years with unknown vaccination status, a single dose of vaccine is recommended 3

The Centers for Disease Control and Prevention recommends pneumococcal vaccination for individuals with chronic cardiovascular disease, chronic pulmonary disease, diabetes mellitus, alcoholism, chronic liver disease, cerebrospinal fluid leaks, and cigarette smoking 1, 4
Vaccination is strongly recommended for individuals with HIV infection, functional or anatomic asplenia, leukemia, lymphoma, Hodgkin disease, multiple myeloma, generalized malignancy, chronic renal failure, nephrotic syndrome, and organ or bone marrow transplantation 1, 4

Residents of nursing homes and long-term care facilities, as well as certain populations with increased risk, such as Alaskan Natives and certain American Indian populations, should receive pneumococcal vaccination 4

Pneumococcal vaccine should be administered at least 2 weeks before elective splenectomy, and at least 2 weeks before initiation of immunosuppressive therapy 4, 5
Vaccination during chemotherapy or radiation therapy should be avoided, and specific vaccination schedules are recommended for hematopoietic stem cell transplant recipients, starting 3-6 months after transplant 5, 6

Pneumococcal vaccine can be administered concurrently with influenza vaccine without increased side effects or decreased antibody response 7
Asplenic patients should be informed that vaccination does not guarantee protection against fulminant pneumococcal disease, which has a case-fatality rate of 50-80% 4

Not recognizing asthma as an indication for pneumococcal vaccination, and failing to vaccinate patients with HIV infection as soon as possible after diagnosis confirmation 1, 4
Missing opportunities to vaccinate during routine healthcare visits, particularly in adults aged 50-64 years with risk factors, and not assessing vaccination status during the adolescent immunization visit at 11-12 years of age 4