What are the recommendations for pneumococcal vaccination in adults?

Updated: Oct 31, 2019
  • Author: Stephanie L Baer, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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The Advisory Committee on Immunization Practices (ACIP) recommends routine use of PCV13 in addition to PPSV23 for adults older than 65 years. It is recommended that an initial dose of PCV13 be given, followed by PPSV23 at least one year later. If PPSV23 has already been given, it should be followed by PCV13 a year later. A second dose of PPSV23 is not needed in immunocompetent hosts. If PPSV23 is inadvertently given prior to 1 year after PCV13, it does not need to be repeated.

In adults aged 19 years and older with immunocompromising conditions (eg, HIV, cancer, renal disease), functional or anatomic asplenia, cerebrospinal fluid leaks, or cochlear implants, it is recommended that they receive PCV13, followed by PPSV23 at least 8 weeks later. In patients who have previously received PPSV23 vaccine, administer 1 dose of PCV13 at least 1 year after the last PPSV23 dose. A second dose of PPSV23 is recommended 5 years after the first dose in persons in this category aged 19-64 years. If the first dose of PPSV23 was administered prior to age 65 years, an additional dose should be administered at age 65 years or at least 5 years after the prior dose. Subsequent doses of PPSV23 should not be given sooner than 8 weeks after a dose of PCV13 and 5 years after the most recent dose of PPSV23. [104]

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