From the Guidelines
Pneumococcal vaccines should be administered according to age and risk factors, with a single dose of PCV21, PCV20, or PCV15 recommended for adults 65 years and older, and PCV15 followed by PPSV23 or a single dose of PCV20 for adults 19-64 years with certain medical conditions, as outlined in the 2024 guidelines 1. The administration of pneumococcal vaccines is crucial for preventing Streptococcus pneumoniae infections, which can cause serious illnesses such as pneumonia, meningitis, and bloodstream infections.
- For adults 65 years and older, the recommended vaccination schedule includes a single dose of PCV21, PCV20, or PCV15, with PCV15 followed by a dose of PPSV23 at least one year later 1.
- For adults 19-64 years with certain medical conditions, such as chronic heart, lung, or liver disease, diabetes, alcoholism, cigarette smoking, or immunocompromising conditions, vaccination is also recommended, typically with PCV15 followed by PPSV23, or a single dose of PCV20 1. Key considerations for pneumococcal vaccine administration include:
- The type of vaccine used (PCV21, PCV20, PCV15, or PPSV23)
- The age and risk factors of the individual
- The timing between different pneumococcal vaccines to ensure optimal immune response and protection
- The need for shared clinical decision-making for certain individuals, such as those with immunocompromising conditions or a history of pneumococcal vaccination 1. It is essential to follow the most recent guidelines, such as those outlined in the 2024 report 1, to ensure that pneumococcal vaccines are administered effectively and safely.
From the Research
Pneumococcal Vaccine Administration
The pneumococcal vaccine is recommended for certain groups of adults, including those with immunocompromising conditions and those aged 65 years and older.
- The 13-valent pneumococcal conjugate vaccine (PCV13) was introduced for US children in 2010 and for immunocompromised adults ≥19 years old in series with the 23-valent polysaccharide vaccine (PPSV23) in 2012 2.
- The Advisory Committee on Immunization Practices (ACIP) recommended routine use of PCV13 among adults aged ≥65 years in 2014, to be administered in series with PPSV23 3.
- Adults with immunocompromising conditions, such as functional or anatomic asplenia, cerebrospinal fluid (CSF) leaks, or cochlear implants, should receive PCV13 in addition to PPSV23 4.
Vaccination Schedule
The vaccination schedule for pneumococcal vaccine administration varies depending on the individual's age and health status.
- Adults aged ≥65 years should receive PCV13 followed by PPSV23 3.
- Adults with immunocompromising conditions should receive PCV13 followed by PPSV23, regardless of age 4.
- The use of PCV13 in series with PPSV23 has been shown to be effective in reducing the incidence of pneumococcal disease among adults 5.
Special Considerations
Certain individuals may require special consideration when it comes to pneumococcal vaccine administration.
- Adults with immunosuppressive therapy may have impaired vaccination responses, and alternative vaccination strategies may be necessary 6.
- The immunogenicity of PCV13 followed by PPSV23 has been investigated in adults with and without immunosuppressive therapy, and the results suggest that vaccination is effective in all groups, although impaired responses were observed in those with immunosuppressive therapy 6.