When should a booster dose of pneumococcal conjugate vaccine (PCV), such as PCV13 (Pneumococcal conjugate vaccine), be given?

PCV13 Booster Dose Timing

For healthy infants completing the primary series, administer the PCV13 booster dose at 12-15 months of age, at least 8 weeks after the third dose. 1, 2

Standard Infant Series (Starting at 2 Months)

• Give the fourth (booster) dose at 12-15 months of age, with a minimum interval of 8 weeks from the third dose 1, 2
• The primary series consists of three doses at 2,4, and 6 months, with minimum 4-week intervals between doses for infants under 12 months 1
• The booster dose completes the standard 4-dose series (3+1 schedule) 2

Catch-Up Schedules for Unvaccinated or Partially Vaccinated Children

Children 7-11 Months at First Dose

• Administer the booster dose at 12-15 months, at least 8 weeks after the second dose 1, 2
• These children receive 2 primary doses (8 weeks apart) followed by the third dose as a booster 1, 2

Children 12-23 Months at First Dose

• No traditional "booster" is given; instead, administer 2 doses total, spaced at least 8 weeks apart 1, 2
• If 2-3 doses were received before 12 months, give 1 dose at least 8 weeks after the most recent dose 1

Children 24-59 Months (Healthy)

• Give 1 supplemental dose if they completed a 4-dose PCV7 series, at least 8 weeks after the most recent dose 1
• For unvaccinated or incompletely vaccinated healthy children in this age range, give 1 dose 1

Special Populations Requiring Additional Doses

Children 24-71 Months with High-Risk Conditions

• Administer 2 doses (8 weeks apart) if they received fewer than 3 doses before age 24 months 1, 3
• Give 1 supplemental dose if they completed a 4-dose series, at least 8 weeks after the most recent dose 1
• High-risk conditions include functional/anatomic asplenia, sickle cell disease, HIV infection, immunocompromising conditions, cochlear implants, or CSF leaks 1, 3

Children 6-18 Years with High-Risk Conditions

• Administer a single dose of PCV13 if not previously received, regardless of prior PCV7 or PPSV23 vaccination 1
• This applies to children with asplenia, immunocompromising conditions, cochlear implants, or CSF leaks 1
• Routine PCV13 use is not recommended for healthy children ≥5 years 1

Critical Timing Considerations

Minimum Intervals

• 8 weeks minimum between any PCV13 doses for children ≥12 months of age 1, 4
• 4 weeks minimum between primary series doses for infants <12 months 1, 2

Transition from PCV7 to PCV13

• Give supplemental PCV13 at least 8 weeks after the last PCV7 dose for children who completed PCV7 series 1
• Children aged 14-59 months who received 4 PCV7 doses should receive 1 supplemental PCV13 dose 1

Coordination with PPSV23

• Administer PPSV23 at least 8 weeks after completing PCV13 in high-risk children ≥2 years 1, 3
• If PPSV23 was given first, wait at least 8 weeks before giving PCV13 1

Common Pitfalls to Avoid

• Do not restart the series if vaccination is delayed; simply continue from where the child left off using age-appropriate catch-up schedules 3, 4
• Do not give PPSV23 before PCV13 in vaccine-naïve children, as this impairs subsequent PCV13 response 3
• Do not skip the booster dose in the infant series, as it is essential for long-term protection and memory B cell development 5
• Do not use intervals shorter than recommended, particularly the 8-week minimum for children ≥12 months 1, 4