Do patients who were vaccinated with PCV13 and one or two doses of PPSV23 before age 65 need an additional dose of PPSV23 at age 65 or later?

Perhaps. CDC recommends two options for people age 65 or older who have immunocompromising conditions, a cochlear implant, or a cerebrospinal fluid (CSF) leak and received PCV13 and either one or two doses of PPSV23 before age 65:

• Option 1: Give a dose of PCV20 or PCV21 at least 5 years after the last pneumococcal vaccine dose
• Option 2: Give a dose of PPSV23 at least 8 weeks after PCV13 and at least 5 years after the previous PPSV23 dose

A patient age 65 or older who received one or two doses of PPSV23 before age 65 but has not received any PCV product, or their history of PCV vaccination is unknown, is recommended to receive a single dose of a currently recommended pneumococcal conjugate vaccine (PCV15, PCV20, or PCV21) at least one year after the last dose of PPSV23.