Editor’s Note: This post was updated in December 2022 to include ACIP’s latest recommendations and March 2023 to include a link to the 2023 Adult Immunization Schedule and CDC’s PneumoRecs VaxAdvisor mobile app.
In October 2021, The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) met to recommended the use of pneumococcal conjugate vaccines (PCV15 and PCV20) for adults. These recommendations were published in the following MMWR.
Highlights of the recommendations include:
- Everyone 65 years or older should receive a pneumococcal conjugate vaccine, either PCV15 or PCV20. If PCV15 is used, this should be followed by a dose of PPSV23. This means there is no longer a shared clinical decision-making recommendation for this age group.
- Everyone 19 through 64 years or older with certain underlying medical conditions or other risk factors should receive a pneumococcal conjugate vaccine, either PCV15 or PCV20. If PCV15 is used, this should be followed by a dose of PPSV23. There is no longer a complex set of recommendations that depend on which condition a patient has; the same recommendation applies regardless of which underlying medical condition or other risk factor is present.
- These new recommendations apply to all adults who have not previously received a pneumococcal conjugate vaccine or whose previous vaccination history is unknown.
In October 2022, ACIP met to review evidence and provide updated pneumococcal vaccine recommendations for adults. During this meeting three votes occurred: one regarding immunocompromised adults who received PCV13 and PPSV23 but have not completed their series, one for adults aged 65 years and older who completed their series with PCV13 and PPSV23, and one for adults who started the series with PCV13 but have not received PPSV23.
Highlights of the new recommendations include:
- Adults with an immunocompromising condition, cochlear implant, or cerebrospinal fluid leak who have received both PCV13 and PPSV23 with incomplete vaccination status are recommended to complete their pneumococcal vaccine series by receiving either a dose of PCV20 at least 5 years after the last pneumococcal vaccine dose or PPSV23 as previously recommended.
- Shared clinical decision-making is recommended regarding administration of PCV20 for adults aged ≥65 years who completed their vaccine series with both PCV13 and PPSV23. If a decision to administer PCV20 is made, a dose of PCV20 is recommended at least 5 years after the last pneumococcal vaccine dose.
- Adults who have received PCV13 only are recommended to receive a dose of PCV20 at least 1 year after the PCV13 dose or PPSV23 as previously recommended to complete their pneumococcal vaccine series.
The CDC published the 2023 Adult Immunization Schedule which includes the new recommendations for the pneumococcal vaccine for adults. Additionally, CDC developed the PneumoRecs VaxAdvisor mobile app that helps vaccination providers quickly and easily determine which pneumococcal vaccines a patient needs and when. Users simply enter a patient’s age, note if the patient has specific underlying medical conditions, and answer questions about the patient’s pneumococcal vaccination history. The app provides patient-specific guidance consistent with the 2023 immunization schedules. Download the app or use the web version.
The National Adult and Influenza Immunization Summit (NAIIS) provided a detailed summary of the pneumococcal vaccination recommendations update that can be accessed here.
Comprehensive immunization programs, which include the promotion and administration of routine vaccines for adults, contribute to the overall health of communities. The updated pneumococcal vaccine recommendations and clinical guidance further bolster efforts which continue to provide the best protection in preventing serious diseases, like pneumonia, meningitis, and bloodstream infections. Local health departments are key in the implementation of updated vaccine recommendations by providing patient and provider education as well as supporting vaccine delivery and administration systems.
