Guidelines to Practice

Update on pneumococcal vaccination in adults: Simpler is better

Craig D. Nielsen, MD, FACP, Joel A. Kammeyer, MD, MPH, FACP and Michael J. Tan, MD, FACP, FIDSA
Cleveland Clinic Journal of Medicine November 2022, 89 (11) 640-642; DOI: https://doi.org/10.3949/ccjm.89a.22047

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Tables

  • TABLE 1

    Recommendations for the initial pneumococcal vaccination in adults who have not yet received a pneumococcal conjugate vaccine

    Age19 to 6465 and older
    No risk factorsaNonePCV20 alone
    or
    PCV15, then PPSV23 in 1 yearb
    With risk factorsPCV20 alone
    or
    PCV15, then PPSV23 in 1 year    		PCV20 alone
    or
    PCV15, then PPSV23 in 1 year

    • ↵a Risk factors include immunodeficiency, iatrogenic immunosuppression, solid-organ transplant recipient, generalized malignancy, Hodgkin disease, leukemia, lymphoma, multiple myeloma, hemoglobinopathies, asplenia, cerebrospinal fluid leak, cochlear implant, human immunodeficiency virus infection, diabetes, alcoholism, tobacco use, and other chronic diseases (heart, kidney, liver, lung).

    • ↵b In patients with a cochlear implant, cerebrospinal fluid leak, or immunocompromising condition, an interval of 8 weeks between PCV15 and PPSV23 can be considered instead of an interval of at least 1 year.

    • PCV15 = 15-valent pneumococcal conjugate vaccine; PCV20 = 20-valent pneumococcal conjugate vaccine; PPSV23 = 23-valent pneumococcal polysaccharide vaccine

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