My patient just turned 65 and has never had a pneumococcal vaccine. What are my options now?

For adults 65 years and older with no prior pneumococcal vaccination or whose previous vaccination history is unknown, you have two options:

• One dose of PCV20 or PCV21 alone, or
• One dose of PCV15 followed by a dose of PPSV23 one year later (if the patient has an immunocompromising medical condition, cochlear implant or cerebrospinal fluid leak consider giving PPSV23 as soon as 8 weeks later).