From the Guidelines
Pneumococcal vaccines should be given according to age and risk factors, with a single dose of PCV21, PCV20, or PCV15 recommended for adults 65 years and older, and a single dose of PCV21, PCV20, or PCV15 for adults 19-64 with certain medical conditions or immunocompromising conditions, as recommended by the Advisory Committee on Immunization Practices in 2024 1. The recommended vaccination schedule varies depending on the individual's age, medical history, and risk factors.
- For adults 65 years and older, a single dose of PCV21, PCV20, or PCV15 is recommended, with PCV15 followed by PPSV23 at least one year later.
- For adults 19-64 with certain medical conditions, such as chronic heart, lung, or liver disease, diabetes, alcoholism, or cigarette smoking, or immunocompromising conditions, such as HIV, cancer, or organ transplants, vaccination is also recommended.
- Children should receive a series of PCV13 or PCV15 starting at 2 months of age, with doses at 2,4,6, and 12-15 months, and high-risk children may also need PPSV23 after age 2. These vaccines protect against Streptococcus pneumoniae, which can cause serious infections, including pneumonia, meningitis, and bloodstream infections, and pneumococcal vaccination is particularly important because these infections can be severe and sometimes fatal, especially in vulnerable populations, and the bacteria has developed resistance to many antibiotics. The most recent guidelines from the Advisory Committee on Immunization Practices in 2024 provide the most up-to-date recommendations for pneumococcal vaccination 1.
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 2.
- Infants should receive the vaccine routinely at 2,4, and 6 months with a fourth dose at 12 to 15 months of age 2.
- The vaccine is also indicated for children 24 to 59 months of age who are at high risk for pneumococcal infection 2, 3.
- For children 7 to 23 months old who have not received previous doses of PCV7, administration of a reduced number of doses is recommended 3.
- Adults at risk for pneumococcal pneumonia, including those over 65 years of age and those with chronic disease, should receive the 23-polysaccharide vaccine 4.
- Immunosuppressed patients of any age should receive both the conjugate and polysaccharide vaccines 4.
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 3.
- Children with sickle cell disease, who may benefit from the vaccine 2, 3.
- Immunocompromised adults, who should receive both the conjugate and polysaccharide vaccines 4.
Vaccine Formulations
There are two main formulations of pneumococcal vaccines:
- The conjugated formulation (PCV), which leads to a more robust and prolonged immune response 5, 6.
- The unconjugated purified polysaccharide (PPSV) formulation, which is also effective but may not provide as long-lasting immunity 4, 6.
- Newer formulations, such as PCV15 and PCV20, offer expanded serotype coverage and may be used in certain clinical situations 6.