If a vaccination provider stocks only PPSV23, what should that provider do for adults now recommended to receive PCV20 or PCV21 alone or PCV15 followed by PPSV23?

Studies have shown that administering the pneumococcal conjugate vaccine (PCV) first leads to a better immune response to serotypes common to both vaccines when the polysaccharide vaccine (PPSV23) is given at a later date. For this reason, CDC recommends that pneumococcal vaccine-naive adults receive PCVs either alone (PCV20, PCV21) or first in a sequence (PCV15 first, followed by PPSV23). A provider who stocks only PPSV23 should consider purchasing a recommended PCV or referring such patients elsewhere to receive a PCV, if feasible. A patient due for PCV who receives PPSV23 first may receive PCV15, PCV20, or PCV21 vaccine at least one year later.