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Pneumococcal Vaccine Updates

Date: 09/24/24

Streptococcus pneumoniae infections can cause pneumonia, meningitis, sepsis and minor infections such as otitis media and sinusitis. There are known risk factors for invasive pneumococcal infections, please refer to table 1 for examples.1 Pneumococcal pneumonia causes 150,000 hospitalizations in the United States each year.2 It causes death in five to seven percent of those infected.2

Vaccination is the best primary prevention against pneumococcal disease. The Centers of Disease Control (CDC) recommends children younger than give and adults 65 and older receive pneumococcal vaccination. There are 2 different types of vaccines available in the United States3:

Pneumococcal conjugate vaccines (PCV’s): PCV15 (Vaxneuvance®), 20 (Prevnar 20®), and 21 (Capaxive™)

Pneumococcal polysaccharide vaccine (PPSV): PPSV-23 (Pneumovax 23®)

The CDC also has a vaccine advisor to help clinicians decide upon the appropriate pneumococcal vaccine to administer to the patient.

Children

The CDC recommends that all children younger than 5 receive a 4 dose PCV vaccine series (PCV15 or PCV20) at the following ages: 2 months, 4 months, 6 months, and 12-15 months.3

Adults 65 years and older

The CDC recommends the following:

Never Vaccinated with PCV15, 20, or 21

  1. Never vaccinated with PCV15, 20 or 21 and never received PPSV13 or 23: They can receive a dose of PCV15, 20, or 21.
    1. If they receive PCV20 or 21, the vaccination series is complete.
    2. If they receive PCV15, administer PPSV 23 within one year
  2. Never vaccinated with PCV15, 20 or 21 and received one dose of PSV 23
    1. Give one dose of PCV15, 20 or 21 one year after PPSV23
  3. Never vaccinated with PCV15, 20 or 21 and received one dose of PPSV 13
    1. Give one dose of PCV15, 20, or 21 one year after PPSV 13
    2. If PPSV23 is given, used shared decision making to decide to give a dose of PCV20 or 21 five years later

Vaccinated with PCV15

  1. In one year, give one dose of PPSV23 to complete vaccine series.

Vaccinated with PCV 20 or 21

  1. Vaccination series is complete.

Please refer to the CDC guidelines for the full vaccine recommendations.

 

Table 1. Risk Factors Pneumococcal Infection (please refer to the guidelines for complete list of risk factors)

Age <5 years old

Age ≥65 years old

Diabetes

Heart Disease

Lung Disease

African American

Indigenous

Immunocompromised patients

Patients in close contact with each other (i.e. daycare, nursing homes, or the unhoused)

 

References

  1. Clinical Overview of Pneumococcal Disease. Accessed September 11, 2024.
  2. Pneumococcal Disease. Accessed September 11, 2024.
  3. Pneumococcal Vaccine Recommendations. Accessed September 11, 2024.