Prevnar Pneumococcal Vaccine Schedule
For Adults ≥65 Years of Age
Adults aged 65 and older should receive a single dose of PCV20 (Prevnar 20) as a one-time vaccination, with no routine revaccination needed. 1, 2
- If you previously received only PPSV23 (Pneumovax), you should get one dose of PCV20 at least 1 year after your last PPSV23 dose 1, 2
- If PCV20 is unavailable, an alternative is PCV15 followed by PPSV23 at least 1 year later 1
- This is a one-time vaccination series—you do not need repeated doses of Prevnar in the future 3
For Adults 19-64 Years with Risk Conditions
Adults aged 19-64 with chronic medical conditions or immunocompromising conditions should receive a single dose of PCV20. 1, 2
Risk conditions include:
- Chronic heart, lung, or liver disease 2
- Diabetes mellitus 4, 2
- Cigarette smoking or alcoholism 2
- Immunocompromising conditions (asplenia, advanced kidney disease, HIV) 4, 2
- Cochlear implants or cerebrospinal fluid leaks 4, 2
This is also a one-time dose with no routine revaccination. 3
For Children and Adolescents
The schedule varies significantly by age:
Infants (Starting at 6 Weeks Through 15 Months)
Administer a 4-dose series at 2,4,6, and 12-15 months of age (with at least 2 months between the third and fourth doses). 3
Catch-Up Vaccination for Previously Unvaccinated Children
- Ages 7-11 months: 3 total doses (first 2 doses at least 4 weeks apart; third dose after first birthday, separated from second dose by at least 2 months) 4, 3
- Ages 12-23 months: 2 doses at least 8 weeks apart 4, 3
- Ages 24 months through 17 years: Single dose 4, 3
Children with High-Risk Medical Conditions (Ages 24-71 Months)
Children with immunocompromising conditions, chronic renal failure, cochlear implants, or CSF leaks should receive 2 doses of PCV13 at least 8 weeks apart if they received fewer than 3 doses before age 24 months. 4
Special Populations
Hematopoietic Stem Cell Transplant Recipients
Receive 4 doses of PCV20: 3 doses given 4 weeks apart starting 3-6 months after transplant, followed by a fourth dose at least 6 months after the third dose or at least 12 months after HSCT, whichever is later. 1, 2
Critical Clinical Pitfalls to Avoid
- Do not revaccinate healthy adults routinely—Prevnar is a one-time vaccination for most adults, not an annual vaccine like influenza 1, 2, 3
- Always wait at least 1 year between PCV20 and prior PPSV23 to optimize immune response 1, 2
- Do not withhold vaccination due to lack of records—use patient verbal history to determine prior vaccination status 1
- Recognize that children with high-risk conditions need additional doses compared to healthy children 4