Examples: Complete Pneumococcal Vaccine Schedules for Adults

Pneumococcal vaccine timing for adults screen shot

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Adults ≥65 years old
Adults 19–64 years old with specified immunocompromising conditions
Adults 19–64 years old with a cochlear implant or cerebrospinal fluid leak

Adults ≥65 years old

adults equal to or over 65 years old
Prior vaccines	Option A	Option B
None^*	PCV20	PCV15 followed by PPSV23 at least 1 year later^†
PPSV23 only, at any age	PCV20 at least 1 year after prior PPSV23	PCV15 at least 1 year after prior PPSV23
PCV13 only, at any age	PCV20 at least 1 year after prior PCV13	PPSV23 at least 1 year after prior PCV13^†
PCV13 at any age and PPSV23 before 65 years	PCV20 at least 5 years after last pneumococcal vaccine dose	PPSV23 at least 5 years after last pneumococcal vaccine dose^§

* Also applies to people who received PCV7 at any age and no other pneumococcal vaccines
† Consider minimum interval (8 weeks) for adults with an immunocompromising condition, cochlear implant, or cerebrospinal fluid leak (CSF) leak
§ For adults with an immunocompromising condition, cochlear implant, or CSF leak, the minimum interval for PPSV23 is ≥8 weeks since last PCV13 dose and ≥5 years since last PPSV23 dose; for others, the minimum interval for PPSV23 is ≥1 year since last PCV13 dose and ≥5 years since last PPSV23 dose

Shared clinical decision-making for those who already completed the series with PCV13 and PPSV23

Shared clinical decision-making for those who already completed the series with PCV13
Prior vaccines	Shared clinical decision-making option
Complete series: PCV13 at any age and PPSV23 at 65 years or older	PCV20 at least 5 years after last pneumococcal vaccine dose Together, with the patient, vaccine providers may choose to administer PCV20 to adults 65 years and older who have already received PCV13 (but not PCV15 or PCV20) at any age and PPSV23 at or after the age of 65 years.

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Adults 19–64 years old with specified immunocompromising conditions

Chronic renal failure

Congenital or acquired asplenia

Congenital or acquired immunodeficiency^¶

Generalized malignancy

HIV infection

Hodgkin disease

Iatrogenic immunosuppression^**

Leukemia

Lymphoma

Multiple myeloma

Nephrotic syndrome

Sickle cell disease/other hemoglobinopathies

Solid organ transplant

¶ Includes B- (humoral) or T-lymphocyte deficiency, complement deficiencies (particularly C1, C2, C3, and C4 deficiencies), and phagocytic disorders (excluding chronic granulomatous disease)
** Includes diseases requiring treatment with immunosuppressive drugs, including long-term systemic corticosteroids and radiation therapy

adults 19 to 64 years old with specified immunocompromising conditions
Prior vaccines	Option A	Option B
None^*	PCV20	PCV15 followed by PPSV23 at least 8 weeks later
PPSV23 only	PCV20 at least 1 year after prior PPSV23	PCV15 at least 1 year after prior PPSV23
PCV13 only	PCV20 at least 1 year after prior PCV13	PPSV23 (dose 1) at least 8 weeks after prior PCV13 and PPSV23 (dose 2) at least 5 years after first dose of PPSV23 Review pneumococcal vaccine recommendations again when your patient turns 65 years old.
PCV13 and 1 dose of PPSV23	PCV20 at least 5 years after last pneumococcal vaccine dose	PPSV23 at least 5 years after last pneumococcal vaccine dose^† Review pneumococcal vaccine recommendations again when your patient turns 65 years old.
PCV13 and 2 doses of PPSV23	PCV20 at least 5 years after last pneumococcal vaccine dose	No vaccines recommended at this time. Review pneumococcal vaccine recommendations again when your patient turns 65 years old.

* Also applies to people who received PCV7 at any age and no other pneumococcal vaccines
† The minimum interval for PPSV23 is ≥8 weeks since last PCV13 dose and ≥5 years since last PPSV23 dose

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Adults 19–64 years old with a cochlear implant or cerebrospinal fluid leak

adults 19 to 64 years old with a cochlear implant or cerebrospinal fluid leak
Prior vaccines	Option A	Option B
None^*	PCV20	PCV15 followed by PPSV23 at least 8 weeks later
PPSV23 only	PCV20 at least 1 year after prior PPSV23	PCV15 at least 1 year after prior PPSV23
PCV13 only	PCV20 at least 1 year after prior PCV13	PPSV23 at least 8 weeks after prior PCV13 Review pneumococcal vaccine recommendations again when your patient turns 65 years old.
PCV13 and 1 dose of PPSV23	PCV20 at least 5 years after last pneumococcal vaccine dose	No vaccines recommended at this time. Review pneumococcal vaccine recommendations again when your patient turns 65 years old.

* Also applies to people who received PCV7 at any age and no other pneumococcal vaccines

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