Which adults ages 19–64 years should receive a second dose of PPSV23 before age 65?

A second PPSV23 given 5 years after the first dose is recommended for people age 19 through 64 years who were vaccinated with PCV13 and PPSV23 and who have one of the following:

• functional or anatomic asplenia (including persons with sickle cell disease or splenectomy patients)
• chronic renal failure (including dialysis patients) or nephrotic syndrome
• immunocompromise (including HIV infection)
• leukemia, lymphoma, Hodgkin disease, multiple myeloma, generalized malignancy
• immunosuppressive therapy (including long-term systemic corticosteroids or radiation therapy)
• solid organ transplant