CDC Updates Recommendations for Pneumococcal Vaccine for Adults

In a Morbidity and Mortality Weekly Report (MMWR) from the United States Centers for Disease Control and Prevention (CDC), public health experts updated pneumococcal vaccination recommendations for adults 19 and older. The updated guidelines recommend that adults who have only had the pneumococcal polysaccharide vaccine (PPSV) get a polysaccharide conjugate vaccine (PCV).

Pneumococcal infections are a type of upper respiratory tract infection caused by Streptococcus pneumaniae, a gram-positive facultative anaerobic bacterium. The infection quickly spreads through respiratory droplets. The bacteria may colonize in severe cases, causing an invasive version of the disease.

Invasive pneumococcal disease (IPD) may include meningitis, osteomyelitis, and septic arthritis.

Understanding the potential risks associated with pneumococcal disease, the CDC’s Advisory Committee on Immunization Practices (ACIP) provided new recommendations to improve vaccine coverage and protection among adults.

Previously, the committee recommended up to two doses of the PPSV23 vaccine, a 23-valent PPSV. The experts had also recommended an alternative, which included one initial dose of the 13-valent PCV vaccine (PCV13) followed by up to three doses of the PPSV23 vaccine. However, in 2021, the US Food and Drug Administration (FDA) approved two new versions of the PCV vaccines, including a 15-valent (PCV15) and a 20-valent (PCV20) version.

Updated guidelines proposed by the ACIP suggested that adults 65 and older, individuals 19–64 with underlying medical conditions, and those with an unknown vaccination status get one stand-alone dose of PCV20 or a dose of PCV15 in series with PPSV23.

Adults who have gotten the PCV13 dose but not the previously recommended PPSV23 vaccines are eligible for a single dose of PCV20 or one or more doses of the PPSV23 vaccine.

“CDC and ACIP will continue to assess the safety of PCV15 and PCV20 use in adults, monitor the impact of implementing these new recommendations, and assess postimplementation pneumococcal disease trends. These vaccines were licensed on the basis of safety and immunogenicity data, and correlates of protection have not been established for adults,” noted CDC officials in the MMWR.