How often is the pneumonia vaccine recommended?

Pneumococcal Vaccine Recommendations

For most adults, a single dose of PCV20 is recommended, with specific revaccination schedules for high-risk individuals and those who have received previous pneumococcal vaccines. 1, 2

General Recommendations by Age Group

Adults aged ≥65 years

• For those with no previous pneumococcal vaccination: Administer a single dose of PCV20 1, 2
• For those who previously received PPSV23 only: Administer a single dose of PCV20 at least 1 year after the last PPSV23 dose 1
• For those who previously received PCV13 only: Administer a single dose of PCV20 at least 1 year after the last PCV13 dose 1
• For those who received both PCV13 and PPSV23 but haven't received PPSV23 at age ≥65 years: Administer a single dose of PCV20 after at least 5 years since the last pneumococcal vaccine dose 1

Adults aged 19-64 years with risk factors

• For those with immunocompromising conditions, CSF leaks, or cochlear implants: Administer a single dose of PCV20 1, 2
• For those with chronic medical conditions: Administer a single dose of PCV20 2

Special Populations and Revaccination

High-risk individuals

• Persons at highest risk (functional or anatomic asplenia, HIV infection, leukemia, lymphoma, Hodgkin's disease, multiple myeloma, generalized malignancy, chronic renal failure, nephrotic syndrome, or other immunosuppressive conditions): Revaccination once is recommended if 5 years have elapsed since the first dose 1
• Children at highest risk for severe pneumococcal infection who would be aged ≤10 years at revaccination: May be revaccinated 3 years after the previous dose 1

Hematopoietic Stem Cell Transplant (HSCT) recipients

• Administer 3 doses of PCV20, 4 weeks apart starting 3-6 months after HSCT
• Follow with a fourth PCV20 dose ≥6 months after the third dose or ≥12 months after HSCT, whichever is later 1, 2

Elderly individuals

• Persons aged ≥65 years should receive a second dose of vaccine if they received the vaccine ≥5 years previously and were aged <65 years at the time of primary vaccination 1
• Elderly persons with unknown vaccination status should be administered one dose of vaccine 1

Important Clinical Considerations

• PCV20 can be administered at the same visit as other age-appropriate vaccines at different anatomic sites 2
• For patients who have received PCV15 but have not completed their recommended pneumococcal vaccine series with PPSV23, one dose of PCV20 may be used if PPSV23 is not available 2
• Always check the patient's prior pneumococcal vaccination history to determine the appropriate timing of vaccination 2
• Revaccination is contraindicated for persons who had a severe reaction (e.g., anaphylactic reaction or localized arthus-type reaction) to the initial dose 1
• Because data are insufficient concerning the safety of pneumococcal vaccine when administered three or more times, revaccination following a second dose is not routinely recommended for most patients 1

Common Pitfalls to Avoid

• Failing to check the patient's prior pneumococcal vaccination history 2
• Not waiting the recommended interval between different pneumococcal vaccines (typically ≥1 year after PCV13 or ≥1 year after PPSV23) 2
• Overlooking the special dosing schedule needed for HSCT recipients 1, 2
• Withholding vaccination in the absence of an immunization record - the patient's verbal history should be used to determine prior vaccination status 1
• Administering unnecessary doses - every patient should be given a record of vaccination 1