When should you get a pneumococcal (pneumonia) vaccine booster?

From the Guidelines

Adults 65 and older should receive a single dose of PCV21, PCV20, or PCV15 as a pneumonia booster if they haven't been previously vaccinated, with PCV15 followed by a dose of PPSV23 at least one year later, as recommended by the most recent guidelines 1. The pneumonia vaccine booster schedule depends on your age and risk factors.

Key Considerations

• For adults 19-64 with certain medical conditions (like chronic heart or lung disease, diabetes, or a weakened immune system), vaccination is recommended with either PCV20 alone or PCV15 followed by PPSV23 1.
• Those who received PPSV23 before age 65 should get another dose of PPSV23 at least 5 years after the previous dose once they turn 65, or consider a single dose of PCV21 or PCV20 if not already received 1.

Vaccine Options

• PCV21, PCV20, or PCV15 are recommended for adults 65 and older who haven't been previously vaccinated 1.
• PCV15 should be followed by a dose of PPSV23 at least one year later for adults 65 and older 1.

Special Considerations

• Adults with an immunocompromising condition, a CSF leak, or a cochlear implant may require a different vaccination schedule, with a minimum interval of 8 weeks between PCV15 and PPSV23 doses 1.
• The pneumococcal vaccination recommendations should be reviewed again when the person reaches age 65 years, and a single dose of PCV21 or PCV20 may be considered if not already received 1.

From the Research

Pneumonia Booster Recommendations

• The Advisory Committee on Immunization Practices (ACIP) recommends a single dose of pneumococcal conjugate vaccine (PCV) for all PCV-naïve adults aged ≥50 years 2.
• Adults aged 19-64 years with risk conditions for pneumococcal disease who have not received a PCV or whose vaccination history is unknown should also receive a PCV 2.
• The ACIP also recommends PCV for adults who started their pneumococcal vaccination series with 13-valent PCV (PCV13) 2.

Effectiveness of Pneumococcal Vaccination

• A prospective, test-negative study found that sequential PCV13/PPSV23 vaccination showed the highest adjusted vaccine effectiveness (VE) of 80.3% against pneumococcal community-acquired pneumonia in adults aged 65-74 years 3.
• The same study found that single-dose PCV13 had an adjusted VE of 66.4%, while PPSV23 had an adjusted VE of 18.5% in the same age group 3.
• A randomized, double-blind, placebo-controlled trial found that 13-valent polysaccharide conjugate vaccine (PCV13) had a vaccine efficacy of 45.6% against community-acquired pneumonia in adults 65 years of age or older 4.

Vaccination Guidelines for Adults with Immunocompromising Conditions

• The ACIP recommends routine use of 13-valent pneumococcal conjugate vaccine (PCV13) for adults aged ≥19 years with immunocompromising conditions, functional or anatomic asplenia, cerebrospinal fluid (CSF) leaks, or cochlear implants 5.
• PCV13 should be administered to eligible adults in addition to the 23-valent pneumococcal polysaccharide vaccine (PPSV23) 5.

Updates to Pneumococcal Vaccination Guidelines

• National guidelines have been updated to incorporate new pneumococcal vaccines, such as PCV15 and PCV20, into clinical practice 6.
• The use of both conjugate and purified polysaccharide modalities in series has produced greater and lasting immunity against pneumococcal disease 6.