It is preferable that the person planning to have the procedure be protected from pneumococcus at the time of the surgery; if possible, administer the appropriate vaccine prior to the splenectomy or cochlear implant. If the procedure is done on an emergency basis, vaccinate as soon as possible after surgery. Adults who have not previously received any pneumococcal vaccine should receive either PCV20 alone or PCV15 followed by PPSV23 at least 8 weeks later.
PCV15 and PCV20 are not licensed or recommended for children younger than 19 years at this time. Children 2 through 71 months of age who are up to date on PCV13 should continue to receive PPSV23 vaccine according to the schedule. They are recommended to receive a second dose of PPSV23 5 years after the first PPSV23 and at least 1 year after their most recent dose of PCV13.