PCV13 Vaccination at 6 Years Old
PCV13 can be given at 6 years old ONLY if the child has specific high-risk medical conditions (anatomic/functional asplenia including sickle cell disease, immunocompromising conditions including HIV, cochlear implant, or CSF leak) and has not previously received PCV13. 1
Key Decision Point: High-Risk Conditions Required
Routine use of PCV13 is NOT recommended for healthy children aged ≥5 years. 1 The ACIP explicitly states that PCV13 administration at this age is reserved exclusively for children with increased risk for invasive pneumococcal disease. 1
Eligible High-Risk Conditions at Age 6
A single dose of PCV13 may be administered to children aged 6-18 years who meet ALL of the following criteria: 1
- Have NOT received PCV13 previously (regardless of prior PCV7 or PPSV23 vaccination) 1
- Have one or more of these conditions: 1
- Anatomic or functional asplenia (including sickle cell disease)
- Immunocompromising conditions (HIV infection, hematologic malignancy, other immunodeficiencies)
- Cochlear implant
- Cerebrospinal fluid (CSF) leak
Sequential Vaccination Strategy for High-Risk Children
If the 6-year-old qualifies based on high-risk conditions: 1
- Administer PCV13 first as a single dose 1
- Follow with PPSV23 at least 8 weeks later (if not previously given) 1
- A second PPSV23 dose is recommended 5 years after the first PPSV23 for children with anatomic/functional asplenia, HIV infection, or other immunocompromising conditions 1
This sequential approach is critical because PCV13 provides superior immunogenicity compared to PPSV23 alone, and giving PCV13 first optimizes the immune response. 1
Critical Pitfall to Avoid
Do not confuse the age 71 months (approximately 6 years) cutoff for children with underlying medical conditions who need catch-up vaccination with the 6-18 years age group recommendation. 1 The 24-71 months recommendation applies to children who had incomplete vaccination schedules before age 24 months, while the 6-18 years recommendation applies to previously unvaccinated children with high-risk conditions. 1
If the Child is Healthy
No PCV13 dose should be given to a healthy 6-year-old child, even if they never received PCV13 or completed only PCV7 series. 1 The routine vaccination window closes at 59 months (approximately 5 years) for healthy children. 1