PCV20 Cannot Be Given at 6,10, and 14 Weeks in Adults
PCV20 is not administered in a multi-dose series at 6-week, 10-week, and 14-week intervals for adults. This dosing schedule does not align with any current Advisory Committee on Immunization Practices (ACIP) recommendations for pneumococcal vaccination in adults aged ≥19 years.
Standard Adult PCV20 Dosing
Adults receive PCV20 as a single dose, not as a multi-dose series. 1 The vaccine is administered once to complete the pneumococcal vaccination series, with timing dependent on prior vaccination history rather than a fixed multi-dose schedule. 1
Recommended Intervals Based on Prior Vaccination
For adults who previously received PCV13 only: Administer a single dose of PCV20 at an interval of ≥1 year after the PCV13 dose. 1
For adults who previously received PPSV23 only: Administer a single dose of PCV20 at an interval of ≥1 year after the last PPSV23 dose. 1
For adults who previously received both PCV13 and PPSV23: Administer a single dose of PCV20 at an interval of ≥5 years after the last pneumococcal vaccine dose. 1
For pneumococcal vaccine-naïve adults aged ≥65 years: Administer a single dose of PCV20 without any prior doses required. 1
The Only Multi-Dose PCV20 Schedule: HSCT Recipients
The single exception to the one-dose rule applies specifically to hematopoietic stem cell transplant (HSCT) recipients, who require a 4-dose series. 1
Dose 1-3: Administer 3 doses of PCV20, each 4 weeks apart, starting 3-6 months after HSCT. 1
Dose 4: Administer the fourth PCV20 dose ≥6 months after the third dose OR ≥12 months after HSCT, whichever is later. 1
This specialized schedule applies exclusively to HSCT recipients and is not used for any other adult population. 1
Why the 6-10-14 Week Schedule Does Not Apply
The intervals of 6 weeks, 10 weeks, and 14 weeks between doses suggest confusion with pediatric vaccination schedules, which use different pneumococcal vaccines (PCV13 or PCV15) in infants. 2 Adult pneumococcal vaccination follows entirely different principles:
Minimum intervals are measured in months or years, not weeks (except for the HSCT 4-week interval between the first three doses). 1
Most adults require only one lifetime dose of PCV20 to complete their pneumococcal vaccination series. 1
Once PCV20 is administered, no additional pneumococcal vaccines are needed in the vast majority of cases. 1
Critical Timing Requirements
For immunocompromised adults (including those with chronic renal failure, HIV infection, malignancies, immunosuppressive therapy, asplenia, or transplant recipients), the minimum interval between PCV13 and PPSV23 can be shortened to ≥8 weeks. 1 However, this shortened interval applies only to the PCV13-to-PPSV23 sequence, not to PCV20 administration, which still requires ≥1 year after prior PCV13. 1
Common Pitfalls to Avoid
Do not confuse adult and pediatric pneumococcal vaccination schedules. Adults do not receive multiple doses at short intervals like infants do. 2
Do not administer PCV20 before the minimum required interval has elapsed since the last pneumococcal vaccine dose, as this violates ACIP recommendations and may result in suboptimal immune response. 1
Do not add PPSV23 after PCV20 administration. Once PCV20 is given, the pneumococcal vaccination series is complete. 1