What is the recommended frequency for administering the pneumococcal (Streptococcus pneumoniae) vaccine?

From the Guidelines

For adults 65 years and older, a single dose of PCV20 is recommended, while for those who have received PCV15, a dose of PPSV23 should be administered at least one year later, as per the latest guidelines from the Advisory Committee on Immunization Practices 1. The pneumococcal vaccination schedule varies based on age and underlying medical conditions.

• For adults aged 65 years and older, the recommended vaccine is either PCV20 or PCV15 followed by PPSV23, with specific intervals between doses depending on previous vaccination history and the presence of immunocompromising conditions 1.
• Adults aged 19-64 years with certain medical conditions, such as chronic heart or lung disease, diabetes, or immunocompromising conditions, should also receive pneumococcal vaccination, typically with PCV15 followed by PPSV23, or a single dose of PCV20 1. Key considerations in determining the vaccination schedule include the individual's risk for pneumococcal disease, time since last pneumococcal vaccination, and risk for exposure to pneumococcal serotypes contained in the vaccine 1. The most recent guidelines from 2023 and 2024 provide updated recommendations for pneumococcal vaccination in adults, emphasizing the importance of shared clinical decision-making for certain groups, such as those with immunocompromising conditions or a history of previous pneumococcal vaccination 1.

From the FDA Drug Label

2 DOSAGE AND ADMINISTRATION

2.3 Vaccination Schedule for Individuals 6 Weeks Through 15 Months of Age Administer Prevnar 20 as a 4-dose series at 2,4,6, and 12 through 15 months of age (and at least 2 months after the third dose).

2.4 Catch-Up Vaccination Schedule for Unvaccinated Individuals 7 Months Through 17 Years of Age Individuals 7 months through 17 years of age who have never received a pneumococcal conjugate vaccine may receive Prevnar 20 according to the schedule in Table 1:

2.5 Catch-Up Vaccination Schedule for Individuals Previously Vaccinated With One or More Doses of a Lower Valency Pneumococcal Conjugate Vaccine Administer a single dose of Prevnar 20 to individuals 15 months through 17 years of age previously vaccinated with one or more doses of a lower valency pneumococcal conjugate vaccine

2.6 Vaccination Schedule for Individuals 18 Years of Age and Older Prevnar 20 is administered as a single dose.

The recommended frequency for administering the pneumococcal (Streptococcus pneumoniae) vaccine varies by age group:

• For individuals 6 weeks through 15 months of age: a 4-dose series at 2,4,6, and 12 through 15 months of age.
• For unvaccinated individuals 7 months through 17 years of age: the schedule is based on the catch-up schedule for Prevnar 13, with the number of doses and timing depending on the age at first dose.
• For individuals 15 months through 17 years of age previously vaccinated with one or more doses of a lower valency pneumococcal conjugate vaccine: a single dose at least 8 weeks after the last dose of the lower valency vaccine.
• For individuals 18 years of age and older: a single dose 2.

From the Research

Pneumococcal Conjugate Vaccine Administration Frequency

The recommended frequency for administering the pneumococcal (Streptococcus pneumoniae) vaccine varies depending on the age group and risk factors.

• For U.S. children, the 13-valent pneumococcal conjugate vaccine (PCV13) and the 23-valent pneumococcal polysaccharide vaccine (PPSV23) have been recommended, with varying schedules by age group and risk group 3.
• A study published in 2014 suggests that schedules of 3 or 4 doses of pneumococcal conjugate vaccine work well, and the differences between these regimens are subtle, especially in a mature program with high coverage and indirect (herd) effects 4.
• Research from 2005 indicates that a 2+1 dose schedule for PCV, with doses administered at 3,5, and 12 months of age, can be effective in inducing satisfactory antibody responses, with the exception of serotypes 6B and 23F 5.
• A randomized clinical trial published in 2013 compared the immunogenicity of 13-valent PCV administered according to 4 different primary immunization schedules in infants and found no statistically significant differences in antibody levels after the booster dose for almost all serotypes 6.
• The US Advisory Committee on Immunization Practices (ACIP) recommends that all infants and children under 24 months of age receive the pneumococcal conjugate vaccine, with a routine schedule of 2,4, and 6 months, and a fourth dose at 12 to 15 months of age 7.

Vaccine Schedules

Different vaccine schedules have been studied, including:

• A 2-4-6 schedule, which was found to be superior to other schedules for certain serotypes 6.
• A 3-5 schedule, which was found to be superior for serotype 1 6.
• A 2+1 dose schedule, which was found to be effective in inducing satisfactory antibody responses 5.

Recommendations

The ACIP recommends the use of PCV15 as an option for pneumococcal conjugate vaccination of persons aged <19 years, according to currently recommended PCV13 dosing and schedules 3.

• Risk-based recommendations on use of PPSV23 for persons aged 2-18 years with certain underlying medical conditions that increase the risk for pneumococcal disease have not changed 3.