Pneumococcal Vaccine Is NOT Given Annually
No, the pneumococcal vaccine is not given annually to any patient population—unlike influenza vaccine, pneumococcal vaccination is typically administered as a one-time dose or limited series with specific intervals between doses, not on an annual basis. 1
Key Distinction from Influenza Vaccine
The most important clinical point is that pneumococcal and influenza vaccines have fundamentally different schedules despite having similar indications:
- Influenza vaccine is administered each year 1
- Pneumococcal vaccine is typically administered only once for persons in most groups 1
- The time of influenza vaccination should be used as an opportunity to identify patients who need pneumococcal vaccine, but this does not mean pneumococcal vaccine is given annually 1
Current Pneumococcal Vaccination Schedule
For Adults ≥65 Years
- Single dose of PCV20 alone completes the series 1, 2
- No additional pneumococcal vaccines are needed after PCV20 2, 3
For Adults 19-64 Years with Risk Conditions
- Single dose of PCV20 alone or PCV15 followed by PPSV23 ≥1 year later 1, 2
- Risk conditions include chronic heart/lung/liver disease, diabetes, smoking, alcoholism, immunocompromising conditions, CSF leak, or cochlear implant 1, 3
For Adults 50-64 Years (Updated 2024)
- Single dose of PCV for all PCV-naïve adults aged ≥50 years, regardless of risk factors 4
Revaccination Scenarios (Not Annual)
The only situations requiring additional pneumococcal doses involve specific intervals measured in years, not annual administration:
- Revaccination ≥6 years after first dose for highest-risk patients (chronic renal failure, nephrotic syndrome, transplant recipients, asplenic patients) who received the older 14-valent vaccine 1
- ≥1 year interval between different pneumococcal vaccine types (e.g., between PPSV23 and PCV20) 1, 2
- ≥5 year interval for adults who received both PCV13 and PPSV23 before considering additional PCV20 1, 2
Common Clinical Pitfall
The most common error is confusing pneumococcal vaccine with influenza vaccine scheduling. While both vaccines are often recommended for the same high-risk populations, only influenza requires annual administration 1. Pneumococcal vaccination provides long-term immunity, with elevated antibody titers documented 5 years after vaccination among healthy adults 1.
Special Population: HSCT Recipients
The only exception to single-dose pneumococcal vaccination is hematopoietic stem cell transplant recipients, who require a 4-dose series of PCV20 starting 3-6 months after transplant, with specific intervals between doses—but this is still not annual vaccination 2, 3.