What is the recommended frequency for pneumococcal (Pneumococcal Conjugate Vaccine) vaccination?

Pneumococcal Vaccination Recommendations

For adults aged ≥19 years, pneumococcal vaccination is recommended as a single dose of PCV20 alone or a dose of PCV15 followed by PPSV23, with no routine revaccination needed except in specific high-risk populations. 1

General Recommendations by Age Group

Adults aged ≥65 years

• For those who have not previously received pneumococcal vaccine: Administer a single dose of PCV20 or a dose of PCV15 followed by PPSV23 ≥1 year later 1
• For those who previously received PPSV23: Administer PCV20 or PCV15 ≥1 year after the last PPSV23 dose 1
• For those who previously received PCV13: Administer PCV20 ≥1 year after PCV13 or PPSV23 ≥1 year after PCV13 1

Adults aged 19-64 years with risk conditions

• For those with chronic medical conditions (heart disease, lung disease, liver disease, diabetes, cigarette smoking, alcoholism): Administer a single dose of PCV20 or PCV15 followed by PPSV23 ≥1 year later 1
• For those with immunocompromising conditions, CSF leak, or cochlear implant: Administer a single dose of PCV20 or PCV15 followed by PPSV23 at a shorter interval (≥8 weeks) 1

Special Populations with Different Vaccination Schedules

Hematopoietic Stem Cell Transplant Recipients

• Administer 3 doses of PCV20 4 weeks apart, starting 3-6 months after HSCT 1
• Follow with a fourth PCV20 dose ≥6 months after the third dose or ≥12 months after HSCT, whichever is later 1
• If PCV20 is unavailable, administer 3 doses of PCV15 4 weeks apart, followed by PPSV23 ≥12 months after HSCT (if no chronic GVHD) 1
• For patients with chronic GVHD, administer a fourth dose of PCV15 instead of PPSV23 1

New 2024 Recommendations with PCV21

• For adults ≥65 years or those with risk factors: A single dose of PCV21 can now be used as an alternative to PCV20 or PCV15+PPSV23 1
• For adults who previously received PCV15 but haven't completed the series with PPSV23, PCV21 or PCV20 may be used if PPSV23 is unavailable 1

Important Considerations

• No routine revaccination is recommended for most adults after receiving the recommended pneumococcal vaccine series 1
• Minimum intervals between vaccines must be respected:
  • ≥1 year between PCV15 and PPSV23 for immunocompetent adults 1
  • ≥8 weeks between PCV15 and PPSV23 for immunocompromised adults 1
  • ≥1 year after previous PPSV23 before administering PCV15 or PCV20 1

Common Pitfalls to Avoid

• Avoid unnecessary revaccination in adults who have completed their recommended pneumococcal vaccine series, as this is not routinely recommended and may increase risk of adverse reactions 1
• Don't miss the shorter interval (≥8 weeks) between PCV15 and PPSV23 for immunocompromised patients, which differs from the longer interval (≥1 year) for immunocompetent adults 1
• Don't overlook the special vaccination schedule for HSCT recipients, which requires multiple doses rather than the single-dose approach for other adults 1
• Don't confuse adult and pediatric pneumococcal vaccination schedules, as they differ significantly in dosing and timing 1

The 2023 ACIP recommendations have simplified the previously complex pneumococcal vaccination schedule, focusing on either a single dose of PCV20 or a PCV15+PPSV23 series for most adults, with special considerations for specific high-risk groups 1.