Recommended Pneumococcal Vaccination Schedule
For adults aged ≥19 years, a single dose of PCV20 is recommended as the preferred pneumococcal vaccination option for most individuals, regardless of previous vaccination status. 1
General Recommendations by Age Group
Adults ≥65 years
- For those with no previous pneumococcal vaccination: Administer a single dose of PCV20 2, 1
- For those previously vaccinated with PPSV23 only: Administer a single dose of PCV20 ≥1 year after the last PPSV23 dose 2, 1
- For those previously vaccinated with PCV13 only: Administer a single dose of PCV20 after a ≥1 year interval since the last PCV13 dose 2
- For those who received both PCV13 and PPSV23 but have not yet received PPSV23 at age ≥65 years: Administer a single dose of PCV20 after a ≥5 year interval since the last PCV13 or PPSV23 dose 2
Adults 19-64 years with Immunocompromising Conditions, CSF Leak, or Cochlear Implant
- For those with no previous pneumococcal vaccination: Administer a single dose of PCV20 2, 1
- Alternative schedule if PCV20 is unavailable: Administer a single dose of PCV15, then after ≥8 weeks, administer a single dose of PPSV23 2
- For those previously vaccinated with PPSV23 only: Administer a single dose of PCV20 after a ≥1 year interval since the last PPSV23 dose 2
Adults 19-64 years with Chronic Medical Conditions
- For those with no previous pneumococcal vaccination: Administer a single dose of PCV20 2, 1
- For those previously vaccinated with PPSV23 only: Administer a single dose of PCV20 after a ≥1 year interval since the last PPSV23 dose 2
- For those previously vaccinated with PCV13 only: Administer a single dose of PPSV23 after a ≥1 year interval since the last PCV13 dose 2
Special Populations
Hematopoietic Stem Cell Transplant (HSCT) Recipients
- For those with no previous vaccination after HSCT: Administer 3 doses of PCV20, 4 weeks apart starting 3-6 months after HSCT, followed by a fourth PCV20 dose ≥6 months after the third dose or ≥12 months after HSCT, whichever is later 2, 1
- Alternative schedule if PCV20 is unavailable: Administer 3 doses of PCV15, 4 weeks apart starting 3-6 months after HSCT, followed by PPSV23 ≥12 months after HSCT if no chronic GVHD 2
- If chronic GVHD is present: Administer a fourth dose of PCV15 in place of PPSV23 2
Important Clinical Considerations
- PCV20 can be administered at the same visit as other age-appropriate vaccines at different anatomic sites 1, 3
- 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 1
- Always check the patient's prior pneumococcal vaccination history to determine the appropriate timing of vaccination 1
- Wait the recommended interval between different pneumococcal vaccines (typically ≥1 year after PCV13 or ≥1 year after PPSV23) 1, 4
Common Pitfalls to Avoid
- Failing to check vaccination history before administering pneumococcal vaccines 1
- Not waiting the appropriate interval between different pneumococcal vaccines, which could lead to suboptimal immune response 1, 4
- Overlooking special dosing schedules for HSCT recipients, who require multiple doses rather than a single dose 2, 1
- Confusing older vaccination schedules with current recommendations, as ACIP guidelines have evolved significantly in recent years 2, 5
- Administering unnecessary doses to patients who have already completed their recommended pneumococcal vaccination series 2