Age | 19 to 64 | 65 and older |
---|---|---|
No risk factorsa | None | PCV20 alone or PCV15, then PPSV23 in 1 yearb |
With risk factors | PCV20 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