ACIP now recommends either PCV20 alone or PCV15 followed by PPSV23 one year later for adults with asthma. Should I vaccinate people with mild, intermittent asthma or exercise-induced asthma?

Yes. Pneumococcal vaccination is recommended for adults age 19 through 64 years with all types of asthma. Available data do not indicate that asthma alone increases the risk of invasive pneumococcal disease among people younger than age 19 years, so pneumococcal vaccination is not currently recommended for people with asthma who are younger than 19.