From the Guidelines
All adults aged 19 years and older should receive pneumococcal vaccination, with specific guidelines based on age and risk factors, as recommended by the Advisory Committee on Immunization Practices (ACIP) in 2023 1.
Pneumococcal Vaccination Guidelines
The ACIP recommends the following pneumococcal vaccination schedules for adults:
- Adults aged 65 years and older should receive a single dose of PCV21, PCV20, or PCV15, and if PCV15 is administered, a single dose of PPSV23 should be administered ≥1 year after the PCV15 dose 1.
- Adults aged 19-64 years with an immunocompromising condition, a CSF leak, or a cochlear implant should receive a single dose of PCV21, PCV20, or PCV15, and if PCV15 is used, administer a single dose of PPSV23 ≥8 weeks after the PCV15 dose 1.
- Adults aged 19-64 years with chronic medical conditions should receive a single dose of PCV21, PCV20, or PCV15, and if PCV15 is administered, a single dose of PPSV23 should be administered ≥1 year after the PCV15 dose 1.
Vaccine Options
The following pneumococcal vaccine options are available:
- PCV21 (21-valent pneumococcal conjugate vaccine)
- PCV20 (20-valent pneumococcal conjugate vaccine)
- PCV15 (15-valent pneumococcal conjugate vaccine)
- PPSV23 (23-valent pneumococcal polysaccharide vaccine)
Administration and Side Effects
Pneumococcal vaccines can be administered at doctor's offices, pharmacies, or health clinics, and most insurance plans cover these vaccines. Side effects are generally mild and include soreness at the injection site, fatigue, and low-grade fever.
Importance of Vaccination
Getting vaccinated is particularly important as we age because our immune systems naturally weaken, making pneumonia more dangerous for older adults. Pneumococcal vaccination can help prevent pneumonia and other serious diseases caused by pneumococcal bacteria.
From the FDA Drug Label
The Advisory Committee on Immunization Practices (ACIP) has recommendations for revaccination against pneumococcal disease for persons at high risk who were previously vaccinated with PNEUMOVAX 23. Routine revaccination of immunocompetent persons previously vaccinated with a 23-valent vaccine, is not recommended.
The pneumococcal polysaccharide vaccine (PNEUMOVAX 23) is used for adults, and the decision for revaccination should be based on the individual's risk factors and the ACIP recommendations.
- The vaccine is administered as a single 0.5-mL dose.
- Revaccination is recommended for persons at high risk, but not for immunocompetent individuals who have previously received a 23-valent vaccine.
- The most common adverse reactions include injection-site pain, swelling, and erythema, as well as headache, asthenia, and myalgia 2.
From the Research
Pneumonia Vaccine for Adults
- The 13-valent pneumococcal conjugate vaccine (PCV13) is recommended for all adults aged ≥65 years and immunocompromised adults aged <65 years to protect against vaccine-serotype invasive pneumococcal disease (IPD) and pneumonia 3.
- PCV13 has demonstrated efficacy against VT-IPD and pneumonia in adults aged ≥65 years, and immune responses to PCV13 in younger adults are comparable or better than in older adults 3.
- The Advisory Committee on Immunization Practices (ACIP) recommends routine use of PCV13 among adults aged ≥65 years, and it should be administered in series with the 23-valent pneumococcal polysaccharide vaccine (PPSV23) 4.
- As of 2024, ACIP recommends a single dose of PCV for all PCV-naïve adults aged ≥50 years 5.
- PCV13 is approved in adults aged ≥50 years and has been shown to elicit a functional immune response and be noninferior to PPSV23 for all 12 serotypes common to the two vaccines 6.
- ACIP also recommends routine use of PCV13 for adults aged ≥19 years with immunocompromising conditions, functional or anatomic asplenia, cerebrospinal fluid (CSF) leaks, or cochlear implants 7.
Eligibility and Administration
- Adults aged ≥50 years are eligible for a single dose of PCV 5.
- Adults aged ≥65 years should receive PCV13 in series with PPSV23 4.
- Immunocompromised adults aged <65 years should receive PCV13 in addition to PPSV23 3, 7.