From the Guidelines
The recommended schedule for Pneumococcal (Streptococcus pneumoniae) vaccination is to administer a single dose of PCV21, PCV20, or PCV15, with a subsequent dose of PPSV23 if necessary, based on the individual's age, health status, and previous vaccination history, as outlined in the most recent guidelines from the Advisory Committee on Immunization Practices (ACIP) 1.
Key Considerations
- For adults aged ≥65 years, a single dose of PCV21, PCV20, or PCV15 is recommended, with a subsequent dose of PPSV23 if necessary, depending on the individual's previous vaccination history 1.
- For adults aged 19-64 years with an immunocompromising condition, a CSF leak, or a cochlear implant, a single dose of PCV21, PCV20, or PCV15 is recommended, followed by a dose of PPSV23 if necessary 1.
- For adults aged 19-64 years with chronic medical conditions, a single dose of PCV21, PCV20, or PCV15 is recommended, with a subsequent dose of PPSV23 if necessary, depending on the individual's previous vaccination history 1.
Vaccine Options
- PCV21: a 21-valent pneumococcal conjugate vaccine that provides protection against 21 serotypes of Streptococcus pneumoniae 1.
- PCV20: a 20-valent pneumococcal conjugate vaccine that provides protection against 20 serotypes of Streptococcus pneumoniae 1.
- PCV15: a 15-valent pneumococcal conjugate vaccine that provides protection against 15 serotypes of Streptococcus pneumoniae 1.
- PPSV23: a 23-valent pneumococcal polysaccharide vaccine that provides protection against 23 serotypes of Streptococcus pneumoniae 1.
Important Notes
- The ACIP recommends shared clinical decision-making for adults aged ≥65 years who have completed the recommended vaccination series with both PCV13 and PPSV23, but have not yet received PCV21 or PCV20 1.
- The pneumococcal vaccination recommendations should be reviewed again when the person reaches age 65 years, or as necessary based on changes in the individual's health status or vaccination history 1.
From the Research
Pneumococcal Vaccination Schedule
The recommended schedule for Pneumococcal (Streptococcus pneumoniae) vaccination varies depending on the country and the individual's age and risk factors.
- In the United States, the American Academy of Pediatrics recommends a 4-dose schedule for children under 2 years old, with doses given at 2,4,6, and 12-15 months of age 2.
- In some European countries, a 3-dose schedule is used, with doses given at 3,5, and 12 months of age 3.
- The World Health Organization recommends a 3-dose schedule, which can be administered as either a 3+0 or 2+1 regimen 4.
- In England and Wales, a 1+1 schedule (3 and 12 months) has been considered as an alternative to the traditional 2+1 schedule, with modeling studies suggesting that it would have little impact on invasive pneumococcal disease cases 5.
- More recently, the 15-valent pneumococcal conjugate vaccine (PCV15) has been approved for use in children aged 6 weeks to 17 years, and can be used according to the currently recommended PCV13 dosing and schedules 6.
Special Considerations
- Children at high risk of invasive pneumococcal infection, such as those with functional or anatomic asplenia, HIV infection, or other predisposing conditions, may require a different vaccination schedule 2.
- The use of pneumococcal polysaccharide vaccine (PPSV23) may be recommended for certain high-risk individuals, particularly those over 2 years old 2, 6.