Should pneumonia titers be checked to determine the needed PCV (Pneumococcal Conjugate Vaccine)?

From the Guidelines

No, you should not check pneumonia titers to determine which pneumococcal conjugate vaccine (PCV) is needed. The selection of PCV vaccine is based on age, risk factors, and vaccination history rather than antibody titers, as stated in the most recent guidelines from 2024 1. For adults, PCV20 or PCV21 is generally recommended for those 65 years and older or younger adults with certain risk factors who haven't previously received a pneumococcal conjugate vaccine. Some key points to consider when selecting a PCV vaccine include:

• Age: Adults 65 years and older should receive a single dose of PCV21, PCV20, or PCV15, with PCV15 followed by a dose of PPSV23 at least 1 year later 1.
• Risk factors: Younger adults with certain risk factors, such as immunocompromising conditions, chronic medical conditions, or a history of pneumococcal disease, should also receive a PCV vaccine 1.
• Vaccination history: The type and timing of previous pneumococcal vaccinations should be taken into account when selecting a PCV vaccine 1. The goal of pneumococcal vaccination is to provide broad protection against the most common disease-causing serotypes based on population-level risk, rather than individual antibody titers 1. Antibody titers against pneumococcal serotypes are not routinely measured in clinical practice because they don't reliably predict protection at an individual level and would add unnecessary cost and complexity to vaccination decisions. Instead, healthcare providers should follow standardized guidelines based on epidemiological data and clinical trials demonstrating efficacy, such as those outlined in the 2024 guidelines 1.

From the Research

Pneumonia Titers and PCV Determination

• The provided studies do not directly address the question of whether pneumonia titers should be checked to determine the needed PCV (Pneumococcal Conjugate Vaccine) 2, 3, 4, 5, 6.
• However, the studies discuss the effectiveness and recommendations for PCV use in different populations, including adults with underlying chronic conditions and those aged 65 years and older 2, 3, 5.
• The studies also compare the immunogenicity of different PCV vaccines, such as PCV13 and PCV15, in adults aged 18 through 49 years 6.
• The cost-effectiveness of using PCV15 or PCV20 in adults aged 65 years and older, as well as those with underlying conditions, is also discussed 5.
• It is worth noting that the studies emphasize the importance of pneumococcal vaccination in preventing pneumococcal disease, particularly in high-risk populations 2, 3, 4, 5.

PCV Recommendations

• The studies provide recommendations for PCV use in different populations, including:
  • Adults aged 65 years and older 2, 3, 5
  • Adults with underlying chronic conditions, such as cardiovascular, liver, and pulmonary diseases, and diabetes mellitus 2, 3, 5
  • Immunocompromised adults 3, 5
• The studies also discuss the use of different PCV vaccines, including PCV13, PCV15, and PCV20, and their effectiveness in preventing pneumococcal disease 2, 3, 5, 6.

Immunogenicity and Cost-Effectiveness

• The studies compare the immunogenicity of different PCV vaccines, including PCV13 and PCV15, in adults aged 18 through 49 years 6.
• The cost-effectiveness of using PCV15 or PCV20 in adults aged 65 years and older, as well as those with underlying conditions, is also discussed 5.
• The studies suggest that PCV20 alone or PCV15 in series with PPSV23 can be cost-effective in preventing pneumococcal disease in high-risk populations 5.