What are the recommendations for pneumococcal (Streptococcus pneumoniae) vaccine for adults?

From the Guidelines

Adults should receive pneumococcal vaccines based on age and risk factors, with the CDC recommending a single dose of PCV21, PCV20, or PCV15 for adults 65 years and older, and PCV21, PCV20, or PCV15 followed by PPSV23 for high-risk adults 19-64 years old, as stated in the most recent guidelines 1.

Key Recommendations

• For adults 65 years and older, a single dose of PCV21, PCV20, or PCV15 is recommended, with PCV15 followed by a dose of PPSV23 at least one year later if PCV15 is used 1.
• For adults 19-64 with certain medical conditions, immunocompromising conditions, or cochlear implants, vaccination is also recommended, with options including PCV21, PCV20, or PCV15, and PPSV23 in some cases 1.
• The vaccines protect against invasive pneumococcal disease by stimulating the immune system to produce antibodies against the bacterial capsular polysaccharides.
• Side effects are generally mild and include injection site pain, fatigue, headache, and muscle pain.
• Pneumococcal vaccination is important because Streptococcus pneumoniae can cause serious infections, including pneumonia, meningitis, and bacteremia, with higher mortality rates in older adults and those with chronic conditions.

Risk Factors

• Chronic heart, lung, or liver disease
• Diabetes
• Alcoholism
• Cigarette smoking
• Immunocompromising conditions, such as HIV, cancer, or organ transplants
• Cochlear implants

Vaccine Options

• PCV21 (21-valent pneumococcal conjugate vaccine)
• PCV20 (20-valent pneumococcal conjugate vaccine)
• PCV15 (15-valent pneumococcal conjugate vaccine)
• PPSV23 (23-valent pneumococcal polysaccharide vaccine)

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 recommendations for pneumococcal vaccine for adults are as follows:

• 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. Key points to consider:
• High-risk individuals may require revaccination against pneumococcal disease.
• Immunocompetent individuals do not require routine revaccination with a 23-valent vaccine 2.

From the Research

Pneumococcal Vaccine Recommendations for Adults

The recommendations for pneumococcal (Streptococcus pneumoniae) vaccine for adults are as follows:

• The Advisory Committee on Immunization Practices (ACIP) recommends a single dose of pneumococcal conjugate vaccine (PCV) for all PCV-naïve adults aged ≥50 years 3.
• Options for PCV include 20-valent PCV (PCV20), 21-valent PCV (PCV21), or 15-valent PCV (PCV15) in series with 23-valent pneumococcal polysaccharide vaccine (PPSV23) 3.
• PCV20 has been shown to induce robust immune responses to all 20 S. pneumoniae serotypes covered by the vaccine and has a tolerability and safety profile similar to that of PCV13 4.
• The use of both conjugate and purified polysaccharide modalities in series has produced greater and lasting immunity against pneumococcal disease 5.

Special Considerations

• Adults aged 19-49 years with risk conditions for pneumococcal disease should follow previous recommendations for PCV vaccination 3.
• Adults who started their pneumococcal vaccination series with 13-valent PCV (PCV13) may receive additional doses of PCV20 or PCV21 3.
• The development of new pneumococcal vaccines, such as PCV15 and PCV20, provides an opportunity to use conjugated vaccines against a wider spectrum of pneumococcal serotypes 5.

Vaccine Types

• Pneumococcal vaccines are available in two formulations: unconjugated purified polysaccharide (PPSV) and conjugated formulation (PCV) 5, 6.
• PCV leads to a more robust and prolonged immune response compared to PPSV 5.
• The introduction of multi-valent pneumococcal vaccines has had a significant effect in reducing the burden of disease caused by S. pneumoniae infection globally 4.