Is pneumococcal vaccination indicated for former smokers younger than age 65?

No, unless chronic lung disease is present, which puts them at increased risk of pneumococcal disease. PCV20 alone or PCV15 followed one year later by PPSV23 is recommended for current smokers of cigarettes age 19 through 64 years (see www.cdc.gov/mmwr/volumes/71/wr/pdfs/mm7104a1-H.pdf).