From the Guidelines
The pneumococcal vaccine is recommended for adults aged 65 and older, as well as for certain younger adults with specific health conditions, with the CDC recommending getting the pneumococcal conjugate vaccine (PCV15 or PCV20) first, and if PCV15 is used, it should be followed by the pneumococcal polysaccharide vaccine (PPSV23) one year later, as stated in the 2023 guidelines by the Advisory Committee on Immunization Practices 1, 2, 3, 4.
Key Recommendations
- For adults 65 and older, the CDC recommends getting the pneumococcal conjugate vaccine (PCV15 or PCV20) first, and if PCV15 is used, it should be followed by the pneumococcal polysaccharide vaccine (PPSV23) one year later 1.
- Most adults only need these vaccines once in their lifetime and do not require regular boosters, but some high-risk individuals may need vaccination before age 65 2.
- Adults aged 19-64 years with a chronic medical condition or immunocompromising condition should receive a single dose of PCV20, or a single dose of PCV15 followed by a dose of PPSV23 at least 1 year later, as recommended by the Advisory Committee on Immunization Practices in 2023 3.
Vaccination Schedule
- The vaccination schedule for adults aged 19-64 years with a chronic medical condition or immunocompromising condition is as follows: + If no vaccine or only PCV7 has been received, administer a single dose of PCV20, or a single dose of PCV15 followed by a dose of PPSV23 at least 1 year later 1. + If PPSV23 only has been received, administer a single dose of PCV20 at least 1 year after the last PPSV23 dose, or a single dose of PCV15 at least 1 year after the last PPSV23 dose, followed by a dose of PPSV23 at least 1 year later 2.
High-Risk Individuals
- Some high-risk individuals, such as those with compromised immune systems, chronic heart or lung disease, diabetes, or those who smoke, may need vaccination before age 65, as recommended by the Advisory Committee on Immunization Practices in 2023 3, 4.
Side Effects
- Side effects of the pneumococcal vaccine are generally mild and may include soreness at the injection site, mild fever, or muscle aches, as reported in the 2023 guidelines by the Advisory Committee on Immunization Practices 1, 2, 3, 4.
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 recommended age for receiving the pneumococcal (pneumonia) vaccine is 50 years of age or older.
- The initial vaccination can be administered to adults at this age.
- Revaccination is recommended for persons at high risk who were previously vaccinated with PNEUMOVAX 23, but routine revaccination of immunocompetent persons is not recommended 5. There is no specific recommended frequency for revaccination for all individuals, as it depends on the individual's risk factors and vaccination history.
From the Research
Pneumococcal Vaccine Recommendations
- The recommended age for receiving the pneumococcal vaccine is ≥50 years, with a single dose of PCV recommended for all PCV-naïve adults in this age group 6.
- Adults aged ≥65 years are recommended to receive a pneumococcal conjugate vaccine (PCV) and a pneumococcal polysaccharide vaccine (PPSV) 7, 8, 9.
- Immunocompromised adults aged <65 years are also recommended to receive PCV13 7.
- The frequency for revaccination is not explicitly stated, but it is recommended that adults who started their pneumococcal vaccination series with 13-valent PCV (PCV13) receive an additional dose of PCV20 or PCV21 6.
Special Considerations
- Adults with underlying chronic conditions, such as cardiovascular, liver, and pulmonary diseases, and diabetes mellitus, are at higher risk for pneumococcal disease and may benefit from vaccination 7.
- Residents of nursing homes and long-term care facilities should have their vaccination status assessed on admission and receive the vaccine as needed 9.
- Sequential PCV13/PPSV23 vaccination has been shown to be effective in preventing pneumococcal community-acquired pneumonia (CAP) in older adults, particularly in those aged 65-74 years 10.