Vaccination Recommendation for 7-Year-Old Post-Invasive Pneumococcal Disease
Yes, your 7-year-old patient who recovered from invasive pneumococcal disease should receive a single dose of PCV13 now, as she meets criteria for high-risk vaccination regardless of prior vaccination history. 1
Rationale for Vaccination
Your patient qualifies for PCV13 vaccination based on her history of invasive pneumococcal disease, which places her in a high-risk category:
Children aged 6–18 years with a history of invasive pneumococcal disease should receive a single dose of PCV13 if they have not received it previously, regardless of whether they received PCV7 or PPSV23 in the past. 1
The CDC explicitly recommends PCV13 for children in this age range who are at increased risk for invasive pneumococcal disease, which includes those with prior invasive disease. 1, 2
Routine use of PCV13 is not recommended for healthy children aged ≥5 years, but your patient is not in the "healthy" category given her disease history. 1, 3
Vaccination Schedule
The approach is straightforward:
If she has received any prior pneumococcal vaccination (PCV7 or PPSV23), ensure at least 8 weeks have elapsed since the most recent dose before giving PCV13. 1, 2
Following PCV13, she should receive PPSV23 at least 8 weeks later to provide broader serotype coverage beyond the 13 serotypes in PCV13. 1, 2
Evidence Supporting This Approach
The recommendation is based on robust guideline evidence:
Post-licensure studies demonstrated 86.0% vaccine effectiveness of PCV13 against vaccine-type invasive pneumococcal disease in children, with particularly strong protection against serotypes 19A (85.6% effectiveness) and 7F (96.5% effectiveness). 4
Even a single dose of PCV13 administered at ≥12 months of age provides 79.2% effectiveness against vaccine-type invasive pneumococcal disease, supporting the single-dose strategy for older children. 5
Children with prior invasive pneumococcal disease remain at risk for subsequent episodes with different serotypes, making vaccination particularly important in this population. 6
Critical Pitfalls to Avoid
Do not assume she is protected simply because she survived invasive pneumococcal disease—natural infection does not provide broad serotype protection. 6
Do not skip PPSV23 after PCV13; the polysaccharide vaccine provides coverage against additional serotypes not included in PCV13 and is essential for high-risk children. 1, 2
Do not delay vaccination while waiting for an arbitrary time period post-infection; once she has clinically recovered, proceed with vaccination. 1
Ensure the 8-week minimum interval is respected if she has received any prior pneumococcal vaccine. 1, 2