Our 65-year-old patient needs PCV15 or PCV20 today, but we only stock PPSV23. Should we give him PPSV23 today and tell him to return in a year for PCV15?

In this case, refer to where the patient may receive either PCV20 alone or PCV15 with plans to receive PPSV23 one year later. ACIP recommends that pneumococcal conjugate vaccine be administered before PPSV23 for optimal immune response to vaccination. If there is a challenge in finding another provider who has PCV15 or PCV20 then administer PPSV23; it is better to give PPSV23 then nothing at all.