How often should adult diabetic patients receive pneumococcal vaccination?

Recommendations vary among adults depending upon age, pneumococcal conjugate (PCV) or polysaccharide (PPSV) vaccination history (including PCV13, PCV15, PCV20, PCV21, and PPSV23), and pneumococcal vaccine products available:

• Adults age 19 or older with diabetes and no history of receiving any PCV20, PCV21, or other pneumococcal vaccination as an adult should receive either PCV20 or PCV21 alone or a series of PCV15 followed in one year by PPSV23. No further doses are recommended.
• People with diabetes who are age 19 through 64 and have already received one dose of PPSV23 may receive one dose of any of the currently recommended PCV options (PCV15, PCV20, or PCV21) one year after the dose of PPSV23; no further doses of PPSV23 are recommended.
• People with diabetes turning 65 who received PCV13 and PPSV23 before age 65, should receive one dose of PCV20, PCV21, or PPSV23. PCV20 or PCV21 should be given at least 5 years after the last pneumococcal vaccination. If using PPSV23, it should be given at least 5 years after the last dose of PPSV23 and at least one year after the last PCV.
• People with diabetes who have already received PCV13 and have received a PPSV23 vaccination since turning 65 are not routinely recommended to receive any additional doses of pneumococcal vaccine. They have the option to receive a dose of PCV20 or PCV21 at least 5 years after their most recent pneumococcal vaccination on the basis of shared clinical decision-making, based upon their risk of pneumococcal disease and desire for additional protection.