From the Guidelines
Pneumococcal vaccines should be given according to age and risk factors, with a single dose of PCV21 recommended for adults 65 years and older, or alternatively, a dose of PCV20 or PCV15 followed by PPSV23 one year later, as recommended by the Advisory Committee on Immunization Practices in 2024 1.
Key Recommendations
- For adults 65 years and older, a single dose of PCV21 is recommended, or alternatively, a dose of PCV20 or PCV15 followed by PPSV23 one year later.
- Adults 19-64 years with certain medical conditions (chronic heart, lung, or liver disease, diabetes, alcoholism, cigarette smoking, cochlear implants, or immunocompromising conditions) should receive pneumococcal vaccination.
- Children should receive a series of PCV13 or PCV15 at 2,4,6, and 12-15 months of age as part of their routine immunization schedule.
Timing of Vaccination
- The timing of pneumococcal vaccination may be adjusted for those who have previously received pneumococcal vaccines.
- For adults who have received PCV15 but have not completed their recommended pneumococcal vaccine series with PPSV23, a single dose of PCV21 or PCV20 may be used if PPSV23 is not available.
High-Risk Groups
- High-risk children may need additional doses of PPSV23.
- Adults with immunocompromising conditions, a CSF leak, or a cochlear implant should receive pneumococcal vaccination according to the recommended schedule.
Vaccine Options
- PCV21, PCV20, and PCV15 are conjugate vaccines that provide protection against pneumococcal disease.
- PPSV23 is a polysaccharide vaccine that provides protection against pneumococcal disease.
References
The recommendations are based on the latest guidelines from the Advisory Committee on Immunization Practices in 2024 1.
From the FDA Drug Label
PNEUMOVAX 23 is approved for use in persons 50 years of age or older and persons aged ≥2 years who are at increased risk for pneumococcal disease.
The pneumococcal vaccine should be given to:
- Persons 50 years of age or older
- Persons aged ≥2 years who are at increased risk for pneumococcal disease It is not approved for use in children less than 2 years of age. 2
From the Research
Pneumococcal Vaccine Administration
The pneumococcal vaccine is recommended for various age groups and individuals with certain health conditions. Key points to consider include:
- The US Advisory Committee on Immunization Practices (ACIP) recommends that all infants and children under 24 months of age receive the vaccine 3.
- Infants should receive the vaccine routinely at 2,4, and 6 months with a fourth dose at 12 to 15 months of age 3.
- The vaccine is also indicated for children 24 to 59 months of age who are at high risk for pneumococcal infection 3, 4.
- For children 7 to 23 months old who have not received previous doses of PCV7, administration of a reduced number of doses is recommended 4.
- Adults at risk for pneumococcal pneumonia, including those over 65 years of age and those with chronic disease, should receive the 23-polysaccharide vaccine 5.
- Immunosuppressed patients of any age should receive both the conjugate and polysaccharide vaccines 5.
Special Considerations
Certain individuals may require special consideration when it comes to pneumococcal vaccine administration, including:
- Children with functional, anatomic, or congenital asplenia, infection with human immunodeficiency virus, and other predisposing conditions 4.
- Children with sickle cell disease, who may benefit from the vaccine 3, 4.
- Immunocompromised adults, who should receive both the conjugate and polysaccharide vaccines 5.
Vaccine Formulations
There are two main formulations of pneumococcal vaccines:
- The conjugated formulation (PCV), which leads to a more robust and prolonged immune response 6, 7.
- The unconjugated purified polysaccharide (PPSV) formulation, which is also effective but may not provide as long-lasting immunity 5, 7.
- Newer formulations, such as PCV15 and PCV20, offer expanded serotype coverage and may be used in certain clinical situations 7.