PCV20 Vaccination Guidelines

Key Principles

The Centers for Disease Control and Prevention (CDC) recommends that if a patient has received PCV20, no additional pneumococcal vaccination is needed—the series is complete 1, 2, 3
PCV20 is a standalone vaccine that provides comprehensive pneumococcal coverage and does not require follow-up with PPSV23 or any other pneumococcal vaccine, as stated by the Advisory Committee on Immunization Practices (ACIP) 6

For Hematopoietic Stem Cell Transplant (HSCT) recipients, a 4-dose PCV20 series is required: 3 doses given 4 weeks apart, starting 3-6 months after HSCT, and a fourth dose given ≥6 months after the third dose OR ≥12 months after HSCT, whichever is later, as recommended by the CDC 1, 3, 7
For adults ≥65 years who already received both PCV13 and PPSV23, shared clinical decision-making may be used to consider an additional dose of PCV20, but only if ≥5 years have passed since the last PCV13 or PPSV23 dose, as suggested by the ACIP 2, 3, 6, 7

The ACIP explicitly states that when PCV20 is used, the pneumococcal vaccination series is complete and need not be followed by additional doses 6
The CDC recommends against reflexively adding PPSV23 after PCV20, as PCV20 stands alone 1, 2, 6
The CDC also recommends against confusing PCV20 with PCV15, as PCV15 requires PPSV23 follow-up, but PCV20 does not 1, 2