People with anatomic asplenia should follow the same recommendations as described for people with immunocompromising conditions. CDC currently recommends that people with immunocompromising conditions who have already received PCV13 should continue to follow the PPSV23 pneumococcal vaccination schedule recommended for people who have had PCV13. Adults with immunocompromising conditions who are younger than age 65 and who have already had PCV13 should receive one dose of PPSV23 at least 8 weeks after the dose of PCV13, then a second dose of PPSV23 at least 5 years later. If the second dose is administered before the age of 65, then a final (3rd) dose of PPSV23 is recommended at least 5 years later, on or after the 65th birthday.
If PPSV23 is due but is unavailable, and PCV20 is available, PCV20 may be given at the visit. No further doses of any type of pneumococcal vaccine are recommended after PCV20 is given.