From the Guidelines
The most recent and highest quality study recommends the use of 21-valent pneumococcal conjugate vaccine (PCV21) among U.S. adults, with specific guidance for different age groups and risk factors, as outlined in the 2024 recommendations of the Advisory Committee on Immunization Practices 1.
Pneumococcal Vaccine Recommendations
The recommendations vary based on age and underlying health conditions.
- For adults aged ≥65 years with no previous pneumococcal vaccination or only PCV7, a single dose of PCV21, PCV20, or PCV15 is recommended, with an additional dose of PPSV23 if PCV15 is used 1.
- For adults aged 19-64 years with immunocompromising conditions, a single dose of PCV21, PCV20, or PCV15 is recommended, with an additional dose of PPSV23 if PCV15 is used, and a minimum interval of 8 weeks can be considered for those with certain conditions 1.
- For adults aged 19-64 years with chronic medical conditions, a single dose of PCV21, PCV20, or PCV15 is recommended, with an additional dose of PPSV23 if PCV15 is used, and the pneumococcal vaccination recommendations should be reviewed again when the person reaches age 65 years 1.
Key Considerations
- The choice of vaccine and dosing schedule depends on the individual's age, health status, and previous vaccination history 1.
- PCV21, PCV20, and PCV15 are conjugate vaccines that provide robust immune responses, while PPSV23 covers more serotypes but may produce a less durable immune response 1.
- Side effects of pneumococcal vaccines are generally mild and temporary, including injection site pain, fatigue, headache, and muscle pain 1.
From the Research
Pneumococcal Vaccine Recommendations
The United States Advisory Committee on Immunization Practices (ACIP) provides recommendations for pneumococcal vaccine use. According to 2, the 13-valent pneumococcal conjugate vaccine (PCV13) and the 23-valent pneumococcal polysaccharide vaccine (PPSV23) have been recommended for U.S. children, with varying recommendations by age group and risk group.
Vaccine Options
- PCV13 is recommended for all children under 19 years of age, according to currently recommended PCV13 dosing and schedules 2.
- PCV15 is an option for pneumococcal conjugate vaccination of persons aged <19 years, as recommended by ACIP in 2022 2.
- PPSV23 is recommended for persons aged 2-18 years with certain underlying medical conditions that increase the risk for pneumococcal disease, with risk-based recommendations 2.
- For adults aged ≥65 years, PCV13 is recommended, as well as for immunocompromised adults aged <65 years 3.
- For adults aged <50 years, PCV13 may be considered for those with underlying chronic conditions, although this is not a standard recommendation 3.
Vaccine Efficacy
- PCV13 has demonstrated efficacy against vaccine-type invasive pneumococcal disease (IPD) and pneumonia in adults aged ≥65 years 4.
- PCV15 contains serotypes 22F and 33F, in addition to the PCV13 serotypes, and has been shown to elicit improved antibody responses compared to PCV13 2.
- PPSV23 has a clinical effectiveness of 43-81% in older adults, although antibody responses may last only 5-10 years 5.