Pneumococcal disease is caused by a bacteria called streptococcus pneumoniae which induces serious illnesses such as pneumonia and sepsis. Therefore, vaccines for this disease have been developed; a 23-valent pneumococcal polysaccharide vaccine (PPSV23 (Pneumovax 23)), a 13-valent pneumococcal conjugate vaccine (PCV13 (Prevnar 13)), and a 7-valent pneumococcal conjugate vaccine (PCV7). Pneumovax 23 was the first vaccine to be introduced to the public in 1983 and recommended for children over 2 years with certain medical conditions and elders over 65 years. Prevnar 13 and PCV7 were developed in the 2000s and used in children. As a result, the infection rate for pneumococcal disease has sharply declined. Even though pneumococcal disease is not a common infection nowadays, it is still crucial to comply with the vaccine schedule. However, the individual vaccine schedule is quite complicated depending on age groups and medical conditions.
Pneumococcal Vaccine Timing for Adults
1 dose of Prevnar 13 is recommended for:
- Adults over19 years with certain medical conditions (cerebrospinal fluid (CSF) leaks, cochlear implants, asplenia, immunocompromised conditions)
- Adults over 65 years without previous history of vaccination (clinician decision making needed)
1 dose of Pneumovax 23 is recommended for:
- Adults over 65 years regardless of the previous history of vaccination
2 doses of Pneumovax 23 are recommended for:
- Adults with certain medical conditions (chronic heart, lung, liver disease, diabetes mellitus, alcoholism, current smoker) and clinical decision making (no Prevnar 13 vaccination)
- 1 dose of Pneumovax 23 at 19 to 65 years
- 1 dose of Pneumovax 23 at over 65 years
1 dose of Prevnar 13 and 2 doses of Pneumovax 23 are recommended for:
- Adults with certain medical conditions (chronic heart, lung, liver disease, diabetes mellitus, alcoholism, current smoker) and clinician decision making (Prevnar 13 vaccination)
- 1 dose of Pneumovax 23 at 19 to 65 years
- 1 dose of Prevnar 13 at over 65 years (at least 1 year apart after Pneumovax 23)
- 1 dose of Pneumovax 23 at over 65 years (at least 1 year apart after Prevnar 13)
1 dose of Prevnar 13 and 2 or 3 doses of Pneumovax 23 are recommended for:
- Adults between 19 to 65 years with certain medical conditions (CSF leaks, Cochlear implants, asplenia, immunocompromised conditions)
- 1 dose Prevnar 13 at 19 to 65 years
- 1 dose of Pneumovax 23 at 19 to 65 years (at least 8 months apart after Prevnar 13)
- 1 dose of Pneumovax 23 at 19 to 65 years (at least 5 years apart after the first dose)
- 1 dose of Pneumovax 23 at over 65 years (at least 5 years apart after the second dose)
PCV7 is recommended for children with 4 dose series at age 2, 4, 6, and 12–15 months and seldomly used for adults. Most adults receive Pneumovax 23, Prevnar 13, or both based on their medical conditions and age. Accordingly, it might help to keep a pneumococcal vaccine schedule on record and discuss it with a primary care provider.
Disclaimer: The patient should always consult with a physician before starting vaccination or new treatment.
Source from: CDC guideline for Pneumococcal vaccine https://www.cdc.gov/mmwr/volumes/68/wr/mm6846a5.htm
