Pneumococcal vaccines

1)Is smoking an indication for pneumococcal vaccine?

• Yes, ACIP reviewed evidence demonstrating an increased risk of invasive
pneumococcal disease among smokers & includes both asthma and cigarette
smoking as indications for pneumococcal vaccination among adults age 19
through 64 years.
2)Do patients who had PMH of proven pneumonia need pneumococcal vaccine?
• Yes. There are more than 100 known serotypes of pneumococcus. Infection with
one serotype does not necessarily produce immunity to other serotypes. As a
result, if the person is a candidate for vaccination, they should receive it even
after one or more episodes of invasive pneumococcal disease.
3)Which pneumococcal vaccine do you recommend now?
(splenectomy, egg allergy, PMH of pneumonia)
• PPSV23, Since it is a polysaccharide vaccine, the patient has egg allergy, conjugate
vaccine(PCV13) is not preferred. PPSV23 should be given every 5 years.
4)What pneumococcal vaccine is going to be available in the near-future?
• PCV15/PCV20. PCV20 can be given if PPSV23 is not available.
5)Is pneumococcal vaccination indicated for former smokers younger than age
65?
• No, unless chronic lung disease is present, which puts them at increased risk
of pneumococcal disease. PCV20 alone or PCV15 followed one year later by
PPSV23 is recommended for current smokers of cigarettes age 19 through 64
years.
6)How has the ACIP recommendation for vaccination of smokers 19 through 64
changed in 2022?
• All are recommended to receive either PCV20 alone or PCV15 followed by
PPSV23 one year later. ACIP no longer recommends the use of PPSV23 alone
for any adult.
7)How often should diabetic patients receive PPSV23?
• With the 2022 published ACIP recommendations for adults, people age 19 or
older with diabetes should receive either PCV20 alone or a series of PCV15
followed in one year by PPSV23. People with diabetes who have already
received PCV13 and have received a PPSV23 vaccination since turning 65 are
not recommended to receive any additional doses of pneumococcal vaccine.
8)Advantages of PCV 15/PCV20:
FDA licensed PCV15 and PCV20 in 2021 based on studies comparing the serologic
response of adults who received either PCV15 or PCV20 to those who received
PCV13. These studies showed PCV15 and PCV20 induced antibody levels
comparable to those induced by PCV13 and shown to be protective against
invasive disease.

Reference: Immunize.org