What are the current recommendations for pneumococcal (pneumonia) vaccination?

From the Guidelines

The current recommendation for pneumococcal vaccination is to administer a single dose of PCV21, PCV20, or PCV15 to adults aged ≥65 years, with the option to administer PPSV23 ≥1 year after PCV15, as outlined in the 2024 guidelines from the Advisory Committee on Immunization Practices 1. The guidelines provide specific recommendations for different age groups and risk factors.

• For adults aged ≥65 years, the options for vaccination include a single dose of PCV21, PCV20, or PCV15, with the additional option of administering PPSV23 ≥1 year after PCV15.
• For adults aged 19-64 years with an immunocompromising condition, a CSF leak, or a cochlear implant, the recommendation is to administer a single dose of PCV21, PCV20, or PCV15, with the option to administer PPSV23 ≥8 weeks after PCV15.
• For adults aged 19-64 years with chronic medical conditions, the recommendation is to administer a single dose of PCV21, PCV20, or PCV15, with the option to administer PPSV23 ≥1 year after PCV15. The 2024 guidelines from the Advisory Committee on Immunization Practices 1 provide the most up-to-date recommendations for pneumococcal vaccination, and healthcare providers should follow these guidelines to ensure optimal protection against pneumococcal disease. Key considerations include the type of vaccine used, the timing of administration, and the individual's risk factors and medical history.
• The conjugate vaccines (PCV) provide longer-lasting protection and help reduce nasopharyngeal carriage of pneumococcal bacteria.
• PPSV23 covers more serotypes but may not be as immunogenic in some populations. By following the current recommendations and considering individual patient factors, healthcare providers can help prevent pneumococcal disease and reduce the risk of morbidity and mortality, particularly in older adults and those with chronic conditions 1.

From the FDA Drug Label

The ACIP has recommendations for use of PNEUMOVAX 23 in children 2 years of age or older, who have previously received pneumococcal vaccines, and who are at increased risk for pneumococcal disease. The Advisory Committee on Immunization Practices (ACIP) has recommendations for revaccination against pneumococcal disease for persons at high risk who were previously vaccinated with PNEUMOVAX 23.

The current recommendations for pneumococcal (pneumonia) vaccination are:

• Children 2 years of age or older who have previously received pneumococcal vaccines and are at increased risk for pneumococcal disease may receive PNEUMOVAX 23, as recommended by the ACIP 2.
• Revaccination against pneumococcal disease is recommended for persons at high risk who were previously vaccinated with PNEUMOVAX 23, as recommended by the ACIP 2. Key points:
• PNEUMOVAX 23 is not approved for use in children less than 2 years of age.
• Routine revaccination of immunocompetent persons previously vaccinated with a 23-valent vaccine is not recommended 2.

From the Research

Pneumococcal Vaccination Recommendations

The current recommendations for pneumococcal vaccination are as follows:

• For adults aged ≥65 years, 13-valent pneumococcal conjugate vaccine (PCV13) is recommended to protect against vaccine-serotype invasive pneumococcal disease (IPD) and pneumonia 3.
• For immunocompromised adults aged <65 years, PCV13 is also recommended 3.
• For adults aged ≥50 years, a single dose of pneumococcal conjugate vaccine (PCV) is recommended for all PCV-naïve adults 4.
• For children, the 13-valent pneumococcal conjugate vaccine (PCV13) and the 23-valent pneumococcal polysaccharide vaccine (PPSV23) have been recommended, with varying recommendations by age group and risk group 5.
• The 15-valent pneumococcal conjugate vaccine (PCV15) is an option for pneumococcal conjugate vaccination of persons aged <19 years, according to currently recommended PCV13 dosing and schedules 5.

Special Considerations

• Adults with underlying chronic conditions, such as cardiovascular, liver, and pulmonary diseases and diabetes mellitus, have a persistent pneumococcal disease burden and may benefit from pneumococcal vaccination 3.
• Children with certain underlying medical conditions, such as functional or anatomic asplenia, infection with human immunodeficiency virus, and other predisposing conditions, are at high risk of invasive pneumococcal infection and may require additional vaccination 6.
• Risk-based recommendations on use of PPSV23 for persons aged 2-18 years with certain underlying medical conditions have not changed 5.

Vaccine Options

• PCV13 is recommended for adults aged ≥65 years and immunocompromised adults aged <65 years 3.
• PCV15 is an option for pneumococcal conjugate vaccination of persons aged <19 years 5.
• PCV20 or PCV21 are options for adults who started their pneumococcal vaccination series with PCV13 4.
• PPSV23 is recommended for high-risk children to expand serotype coverage 6.