My 43-year-old patient who is about to undergo a splenectomy received PCV15 followed by PPSV23 eight weeks later in preparation for the procedure. When should she get her next dose of PPSV23?

At this time, ACIP does not recommend revaccination with PPSV23 for adults younger than 65 who are at the highest risk of pneumococcal disease (including those with asplenia) who receive PCV15 (Vaxneuvance) followed by PPSV23.

If an adult patient with asplenia receives PCV13 (Prevnar 13) followed by PPSV23, ACIP recommends continuing the previously recommended schedule for patients with immunocompromising conditions (including asplenia) who receive that vaccine combination. In that case, the patient would be revaccinated with PPSV23 at least 5 years following the first dose. If dose 2 is administered when the patient is younger than 65, then dose 3 is due at least 5 years later and after the patient turns 65.

If an adult patient with asplenia receives a dose of PCV20, ACIP does not recommend further doses of any pneumococcal vaccine.