How often should a healthy adult receive the Pneumovax (Pneumococcal Polysaccharide Vaccine) vaccine?

Pneumococcal Vaccination Schedule for Healthy Adults

For healthy adults, a single dose of pneumococcal vaccine (PCV20) is recommended at age 65 years with no need for revaccination. 1

Current Recommendations for Healthy Adults

Adults Under 65 Years

• Healthy adults under 65 years without risk factors do not routinely need pneumococcal vaccination 1
• No routine revaccination is recommended for this population

Adults 65 Years and Older

• For adults reaching age 65 with no previous pneumococcal vaccination:
  • Preferred option: Single dose of PCV20 1
  • Alternative option: PCV15 followed by PPSV23 (Pneumovax) ≥1 year later 1
• For adults who previously received PPSV23 before age 65:
  • Administer PCV20 ≥1 year after the last PPSV23 dose 1

Vaccination Algorithm Based on Previous Vaccination History

For Adults ≥65 Years with No Previous Pneumococcal Vaccination

1. Administer a single dose of PCV20
2. No revaccination needed

For Adults ≥65 Years with Previous PPSV23 Only

1. Administer PCV20 ≥1 year after the last PPSV23 dose
2. No additional doses needed

For Adults ≥65 Years with Previous PCV13 Only

1. Administer PCV20 ≥1 year after the PCV13 dose
2. No additional doses needed

For Adults ≥65 Years with Both PCV13 and PPSV23 Previously

• If PPSV23 was given at age ≥65 years: No additional vaccination needed routinely
• If PPSV23 was given before age 65: Consider PCV20 ≥5 years after the last pneumococcal vaccine dose 1

Important Clinical Considerations

• The 2023 CDC guidelines have simplified the pneumococcal vaccination schedule, moving away from routine revaccination for healthy adults 1
• PCV20 provides broader and more durable protection than the older PPSV23 (Pneumovax) vaccine 2
• PCVs (PCV15/PCV20) have immunologic advantages over PPSV23, including better immune memory and longer-lasting protection 2
• Sequential PCV13/PPSV23 vaccination showed the highest effectiveness (80.3%) in adults aged 65-74 years in recent studies 3

Common Pitfalls to Avoid

• Avoid unnecessary revaccination of healthy adults who have already received a pneumococcal vaccine at age ≥65 years
• Don't confuse recommendations for healthy adults with those for immunocompromised patients, who require different vaccination schedules
• Remember that the previous recommendation for routine revaccination with PPSV23 after 5 years is no longer applicable for healthy adults
• Ensure vaccination status is reassessed at age 65 for all adults 2

The current evidence strongly supports a single-dose strategy for healthy adults at age 65, with no routine revaccination needed thereafter. This approach simplifies the previous more complex recommendations while maintaining protection against pneumococcal disease.