Pneumococcal Vaccine Recommendations

Below are summaries of recommendations from CDC’s Advisory Committee on Immunization Practices (ACIP). For the full text of the recommendations, see Pneumococcal ACIP Vaccine Recommendations.

Vaccination of Infants, Children, and Adults 65 Years or Older

CDC recommends routine administration of pneumococcal conjugate vaccine (PCV13) for all children younger than 2 years of age:

  • Give PCV13 to infants as a series of 4 doses, one dose at each of these ages: 2 months, 4 months, 6 months, and 12 through 15 months.
  • Children who miss their shots or start the series later should still get the vaccine. The number of doses recommended and the intervals between doses will depend on the child’s age when vaccination begins.

CDC recommends routine administration of pneumococcal polysaccharide vaccine (PPSV23) for all adults 65 years or older. In addition, CDC recommends PCV13 based on shared clinical decision-making for adults 65 years or older who do not have an immunocompromising condition†, cerebrospinal fluid leak, or cochlear implant and have never received a dose of PCV13. Clinicians should consider discussing PCV13 vaccination with these patients to decide if vaccination might be appropriate. See Pneumococcal Vaccination: Summary of Who and When to Vaccinate for CDC guidance for shared clinical decision-making.

Expert Commentary

CDC, Medscape from WebMD

CDC-Medscape video: Updated Pneumococcal Vaccine Recommendations for Older Adults

CDC Commentary – Updated Recommendations for PCV13 Use in Older Adultsexternal icon

Running Time: 5:08 mins
Date Released: 01/31/2020

Learn about considerations for this new shared clinical decision-making recommendation.
  • For adults 65 years or older who do not have an immunocompromising condition, cerebrospinal fluid leak, or cochlear implant and want to receive PPSV23 ONLY:
    • Administer 1 dose of PPSV23.
      • Anyone who received any doses of PPSV23 before age 65 should receive 1 final dose of the vaccine at age 65 or older. Administer this last dose at least 5 years after the prior PPSV23 dose.
  • For adults 65 years or older who do not have an immunocompromising condition, cerebrospinal fluid leak, or cochlear implant and want to receive PCV13 AND PPSV23:
    • Administer 1 dose of PCV13 first then give 1 dose of PPSV23 at least 1 year later.
      • If the patient already received PPSV23, give the dose of PCV13 at least 1 year after they received the most recent dose of PPSV23.
      • Anyone who received any doses of PPSV23 before age 65 should receive 1 final dose of the vaccine at age 65 or older. Administer this last dose at least 5 years after the prior PPSV23 dose.

Footnote

† Immunocompromising conditions include: chronic renal failure, nephrotic syndrome, immunodeficiency, iatrogenic immunosuppression, generalized malignancy, human immunodeficiency virus, Hodgkin disease, leukemia, lymphoma, multiple myeloma, solid organ transplants, congenital or acquired asplenia, sickle cell disease, or other hemoglobinopathies.

Vaccination of Older Children and Adults with Certain Indications

In certain situations, children 2 years or older and adults should also receive pneumococcal vaccines. See Pneumococcal Vaccination: Summary of Who and When to Vaccinate for all pneumococcal vaccine recommendations by vaccine and age.

Catch-up Guidance for Children 4 Months through 18 Years

Graphic of someone holding a mobile phone displaying the PnuemoRecs VaxAdvisor app. PneumoRecs VaxAdvisor: Customized pneumococcal vaccination recommendations at your fingertips.

PneumoRecs VaxAdvisor is available for download on iOS and Android mobile devices.

The following “job-aid” provides catch-up guidance for PCV13 for children 4 months through 18 years of age. It includes detailed scenarios by age group and previous number of doses received. This should assist clinicians in interpreting Figure 2 of the Childhood/Adolescent Immunization Catch-up Schedule.

Contraindications and Precautions

Do not administer PCV13 to:

  • A person who has ever had a severe allergic reaction (e.g., anaphylaxis) after a previous dose of PCV7 or PCV13 or to any vaccine containing diphtheria toxoid
  • A person with a severe allergy to any component of this vaccine

Do not administer PPSV23 to:

  • A person who has ever had a severe allergic reaction (e.g., anaphylaxis) after a previous dose
  • A person with a severe allergy to any component of this vaccine

Clinicians may administer pneumococcal vaccines, if the provider and parent or patient deems the benefits of vaccination to outweigh the risks, to:

  • A person who has a moderate or severe acute illness with or without fever

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Page last reviewed: November 21, 2019