Our 56-year-old patient needs a pneumococcal conjugate vaccine (PCV) today, but we only stock PPSV23. Should we give him PPSV23 today and tell him to return in a year for PCV?

In this case, it is preferable to refer to a vaccination provider who can administer either PCV20 or PCV21 alone or PCV15 with plans to receive PPSV23 one year later. ACIP recommends that PCV15 be administered before PPSV23 for optimal immune response to vaccination. If there is a challenge in finding another location where the patient can receive a recommended PCV option, it is better to give PPSV23 than nothing at all.