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

Either a second PPSV23 or a dose of PCV20 or PCV21 should be given 5 years after the first dose of PPSV23 for people age 19 through 64 years who were vaccinated with PCV13 and PPSV23 and who have one of the following immunocompromising conditions:

• Kidney disease and on maintenance dialysis
• Kidney disease with nephrotic syndrome
• Asplenia or splenic dysfunction
• Congenital or acquired immunodeficiency, including B-(humoral) or T-lymphocyte deficiency; complement deficiencies, particularly C1, C2, C3, and C4 deficiency; and phagocytic disorders (excluding chronic granulomatous disease)
• Treatment with immunosuppressive drugs or radiation therapy (including treatment for Hodgkin disease, leukemias, lymphomas, malignant neoplasm, and solid organ transplant)
• HIV infection
• Sickle cell disease or other hemoglobinopathies