Stay informed with the latest ACIP updates on pneumococcal vaccine recommendations for adults, ensuring optimal protection against the disease.

Introduction

Pneumococcal disease poses a significant health risk, especially to adults aged 65 and older and those with underlying health conditions. The Advisory Committee on Immunization Practices (ACIP) has recently updated its pneumococcal vaccine recommendations, aiming to enhance protection and simplify vaccination protocols. This update is crucial for healthcare providers and individuals seeking to safeguard against pneumococcal infections.

Latest ACIP Updates

In April 2022, the Centers for Disease Control and Prevention (CDC) approved new recommendations for pneumococcal vaccines. The ACIP now endorses the use of either the 20-valent pneumococcal conjugate vaccine (PCV20) alone or the 15-valent pneumococcal conjugate vaccine (PCV15) in combination with the 23-valent pneumococcal polysaccharide vaccine (PPSV23) for:

All adults aged 65 years or older
Adults aged 19 to 64 years with certain underlying medical conditions or risk factors

These updated guidelines replace the 2019 recommendations, which involved more complex clinical decision-making processes and the use of PCV13 in select older adults. The new recommendations offer broader protection by covering additional pneumococcal serotypes.

“It’s good news that more pneumococcal serotypes are now targeted with PCVs,” said John D. Grabenstein, PhD, RPh, director of scientific communication for Immunize.org. “Of greatest importance is reaching the millions of adults who have never received the protection of pneumococcal vaccines or are not up to date on their adult vaccines.”

Vaccination Options

PCV20

PCV20 provides comprehensive protection against 20 serotypes of pneumococcal bacteria. When administered alone, no additional doses are necessary, simplifying the vaccination schedule for patients.

PCV15 and PPSV23

For those opting for PCV15, it should be administered in series with PPSV23. The recommended interval between PCV15 and PPSV23 is at least one year. However, for adults who are immunocompromised or have cochlear implants, the interval can be reduced to a minimum of 8 weeks.

“The use of PCV15 or PCV20 offers patients a vaccine option with protection against additional pneumococcal serotypes,” emphasized Maria G. Tanzi, PharmD.

Dosing Intervals and Coadministration

PCV20 Alone: No further doses required.
PCV15 + PPSV23: Minimum one-year interval between doses.
Special Populations: Minimum 8-week interval for immunocompromised individuals or those with cochlear implants.

All forms of pneumococcal vaccines (PCV15, PCV20, or PPSV23) can be coadministered with quadrivalent inactivated influenza vaccines. Currently, there is limited data on coadministration with other vaccines, including COVID-19 vaccines, which are under evaluation.

Clinical Considerations

Healthcare providers, including pharmacists, should:

Update Vaccine Records Accurately: Clearly document whether PPSV23, PCV15, or PCV20 was administered.
Educate Patients: Inform patients about the vaccination schedule, potential adverse effects such as injection site pain, fatigue, and myalgia, and the importance of completing the vaccine series if necessary.
Utilize Available Tools: The CDC’s PneumoRecs VaxAdvisor mobile app can assist in determining the appropriate pneumococcal vaccines based on patient-specific factors.

“This is only an intermediate step as pneumococcal vaccines with additional serotypes are approved,” said Stephan Foster, PharmD, FAPhA, CAPT (Ret), USPHS.

Conclusion

The updated pneumococcal vaccine recommendations by the ACIP represent a significant advancement in adult immunization strategies. By simplifying the vaccination process and expanding protection against more serotypes, these guidelines aim to reduce the burden of pneumococcal disease among adults. Healthcare providers and patients alike should stay informed and adhere to these recommendations to ensure optimal health outcomes.

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