From the Guidelines
For pneumonia vaccination, the current recommendation is to receive one dose of PCV15 or PCV20 for most adults aged 65 and older, with PCV15 followed by a dose of PPSV23 one year later if PCV15 is used. The options for vaccinating against pneumonia vary based on age and underlying medical conditions.
Key Recommendations
- For adults aged 65 and older, the recommendation is to receive one dose of PCV15 or PCV20, with PCV15 followed by a dose of PPSV23 one year later if PCV15 is used 1.
- For adults aged 19-64 with certain medical conditions, such as chronic heart, lung, or liver disease, diabetes, alcoholism, cigarette smoking, or immunocompromising conditions, vaccination is also recommended, typically starting with PCV15 or PCV20 1.
- Children should receive a series of PCV13 at 2,4,6, and 12-15 months of age.
Booster Schedules
- Unlike some vaccines, pneumococcal vaccines generally don't require regular boosters after the initial recommended doses are completed.
- However, for adults with immunocompromising conditions, a second dose of PPSV23 may be recommended after a ≥5 year interval since the last PPSV23 dose 1.
Vaccine Options
- Pneumococcal Conjugate Vaccine (PCV13 or Prevnar 13)
- Pneumococcal Polysaccharide Vaccine (PPSV23 or Pneumovax 23)
- PCV15 and PCV20 are newer vaccines that cover more strains of pneumococcal bacteria than PCV13.
Important Considerations
- The vaccines target different strains of the bacteria, with PCV13/15/20 covering fewer but more common strains, while PPSV23 covers more strains but may produce a less robust immune response.
- These vaccines work by stimulating the immune system to produce antibodies against the pneumococcal bacteria, which are a common cause of pneumonia. The most recent and highest quality study, published in 2024, provides the most up-to-date recommendations for pneumococcal vaccination 1.
From the Research
Vaccination Options
- Pneumococcal conjugate vaccines (PCVs) are available to provide protection against vaccine serotype pneumococcal pneumonia 2, 3, 4.
- The 13-valent conjugated vaccine is recommended for children at risk for pneumococcal pneumonia, while adults at risk should receive the 23-polysaccharide vaccine 5.
- Immunocompromised patients of any age should receive both vaccines 5.
Recommended Ages and Booster Schedules
- The US Advisory Committee on Immunization Practices (ACIP) recommends that all infants and children under 24 months of age receive the pneumococcal conjugate vaccine 2.
- Infants should receive the vaccine routinely at 2,4, and 6 months with a fourth dose at 12 to 15 months of age 2, 6.
- Children 24 to 59 months of age who are at high risk for pneumococcal infection should also receive the vaccine 2, 6.
- Adults at risk for pneumococcal pneumonia should receive the 23-polysaccharide vaccine, with revaccination once at age 65 years or older provided that at least 5 years have elapsed since the previous vaccination 5.
- Different dosing schedules, including 2+1,3+0, and 3+1, have been shown to be effective in reducing vaccine-type invasive pneumococcal disease among young children 3, 4.
Special Considerations
- Children with sickle cell disease, human immunodeficiency virus infection, and other predisposing conditions are at high risk for pneumococcal infection and should receive the vaccine 2, 6.
- Antibiotic prophylaxis is recommended for children younger than 5 years with functional or anatomic asplenia, including children with sickle cell disease 6.