All adults ≥65 years of age |
Adults 19-64 years of age with any of the following: |
Predisposing medical conditions:
|
Increased risk of meningitis:
|
Immunocompromising conditions and other conditions associated with altered immunocompetenceΔ:
|
History of invasive pneumococcal disease† |
PCV20: 20-valent pneumococcal conjugate vaccine; PCV15: 15-valent pneumococcal conjugate vaccine; PPSV23: 23-valent pneumococcal polysaccharide vaccine.
* Including congestive heart failure and cardiomyopathies, excluding hypertension.
¶ Including chronic obstructive pulmonary disease, emphysema, and asthma.
Δ Some UpToDate authors differ from ACIP guidance on vaccine selection for immunocompromised individuals. Refer to the UpToDate text on pneumococcal vaccination in adults for additional information.
◊ Includes B (humoral) or T lymphocyte deficiency, complement deficiencies (particularly C1, C2, C3, and C4 deficiencies), and phagocytic disorders (excluding chronic granulomatous disease).
§ HIV infection is an indication for pneumococcal vaccination, regardless of CD4 cell count.
¥ Treatment with any immunosuppressive drugs (including long-term glucocorticoids, tumor necrosis factor alpha inhibitors, cancer chemotherapy, and other cytokine inhibitors) or radiation therapy.
‡ Chronic kidney disease is defined as glomerular filtration rate <60 mL/min/1.73 m2 for ≥3 months.
† The United States Centers for Disease Control and Prevention Advisory Committee on Immunization Practices (ACIP) does not mention individuals with a prior history of invasive pneumococcal disease in their recommendations on pneumococcal vaccinations. We suggest pneumococcal vaccination in this population due to their increased risk for recurrent pneumococcal disease. Refer to the UpToDate text on pneumococcal vaccination in adults for additional detail.