The Advisory Committee on Immunization Practices, or ACIP, voted in June 2019 to change the pneumococcal vaccine recommendations for older adults. Hello. I'm Dr Miwako Kobayashi, a medical epidemiologist at the Centers for Disease Control and Prevention (CDC). I hope to shed some light on what the new recommendation means and give you ideas on how to implement it in your practice.
Let's set the stage with some background information. CDC used to recommend routine use of two pneumococcal vaccines for all adults aged 65 years or older. The first is the 13-valent pneumococcal conjugate vaccine, PCV13, which is sold under the trade name of Prevnar 13. The second vaccine is the 23-valent pneumococcal polysaccharide vaccine, PPSV23, sold under the trade name of Pneumovax 23.
PCV13 is now recommended on the basis of shared clinical decision-making rather than routinely for all adults aged 65 years or older who have never received PCV13. This simply means that together, the patient and provider can decide whether PCV13 is right for that specific person. This change applies to older adults who do not have an immunocompromising condition, cerebrospinal fluid leak, or cochlear implant. PCV13 is still routinely recommended for older adults with those conditions
Pneumococcal Infections (Streptococcus pneumoniae)
Pediatric Pneumococcal Infections
Rapid Review Quiz: Pneumococcal Infections
COMMENTARY
Updated Pneumococcal Vaccine Recommendations for Older Adults
Miwako Kobayashi, MD, MPH
DisclosuresJanuary 31, 2020
Editorial Collaboration
Medscape &
The Advisory Committee on Immunization Practices, or ACIP, voted in June 2019 to change the pneumococcal vaccine recommendations for older adults. Hello. I'm Dr Miwako Kobayashi, a medical epidemiologist at the Centers for Disease Control and Prevention (CDC). I hope to shed some light on what the new recommendation means and give you ideas on how to implement it in your practice.
Let's set the stage with some background information. CDC used to recommend routine use of two pneumococcal vaccines for all adults aged 65 years or older. The first is the 13-valent pneumococcal conjugate vaccine, PCV13, which is sold under the trade name of Prevnar 13. The second vaccine is the 23-valent pneumococcal polysaccharide vaccine, PPSV23, sold under the trade name of Pneumovax 23.
PCV13 is now recommended on the basis of shared clinical decision-making rather than routinely for all adults aged 65 years or older who have never received PCV13. This simply means that together, the patient and provider can decide whether PCV13 is right for that specific person. This change applies to older adults who do not have an immunocompromising condition, cerebrospinal fluid leak, or cochlear implant. PCV13 is still routinely recommended for older adults with those conditions
Public Information from the CDC and Medscape
Cite this: Updated Pneumococcal Vaccine Recommendations for Older Adults - Medscape - Jan 31, 2020.
Tables
If PCV13 has been given, then give PPSV23 ≥ 1 year after PCV13
If PCV13 has been given, then give PPSV23 ≥ 1 year after PCV13
≥ 5 years after any PPSV23 at age
< 65 years
≥ 8 weeks after PCV13
If no previous PCV13 vaccination
≥ 8 weeks after PCV13
≥ 5 years after any PPSV23 at
< 65 years
1st dose ≥ 8 weeks after PCV13
If no previous PCV13 vaccination
≥ 8 weeks after PCV13
≥ 5 years after any PPSV23 at
< 65 years
Abbreviations: ✔ = Recommended vaccination; CSF = cerebrospinal fluid; HIV = human immunodeficiency virus.
* This PPSV23 column only refers to adults aged 19–64 years. All adults aged ≥ 65 years should receive one dose of PPSV23 ≥ 5 years after any previous PPSV23 dose, regardless of previous history of vaccination with pneumococcal vaccine. No additional doses of PPSV23 should be administered following the dose administered at age ≥ 65 years.
† Recommendations that changed in 2019
§ Including congestive heart failure and cardiomyopathies
¶ Including chronic obstructive pulmonary disease, emphysema, and asthma
** Includes B- (humoral) or T-lymphocyte deficiency, complement deficiencies (particularly C1, C2, C3, and C4 deficiencies), and phagocytic disorders (excluding chronic granulomatous disease)
†† Diseases requiring treatment with immunosuppressive drugs, including long-term systemic corticosteroids and radiation therapy
Authors and Disclosures
Authors and Disclosures
Author
Miwako Kobayashi, MD, MPH
Medical Epidemiologist, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Disclosure: Miwako Kobayashi, MD, MPH, has disclosed no relevant financial relationships.