Table 1.

Timeline of Advisory Committee on Immunization Practices Adult Pneumococcal Vaccination Recommendations^*

Year	Adult Pneumococcal ACIP Recommendations	References
1984	PPSV23 recommended for adults aged ≥65 years	3
1989	In addition to adults ≥65, PPSV23 also recommended for- Adults aged 19 to 64 years with chronic illness, including cardiovascular disease, pulmonary disease, diabetes mellitus, alcoholism, cirrhosis, CSF leaks Adults aged 19 to 64 years with immunocompromising conditions, including splenic dysfunction, anatomic asplenia, Hodgkin disease, lymphoma, multiple myeloma, chronic renal failure, nephrotic syndrome, organ transplantation, HIV	4
1997	Added specificity to previous indications: Cardiovascular disease to include congestive heart failure and cardiomyopathies Chronic pulmonary disease to include chronic obstructive pulmonary disease and emphysema, but not asthma	5
	Added PPSV23 recommendation for adults aged 19 to 64 years who live in an environment in which the risk of invasive pneumococcal disease or its complications is increased (eg, Alaskan Natives and certain American Indian populations, and patients in nursing homes) have generalized malignancy receive immunosuppressive chemotherapy
	Added recommendation for revaccination with PPSV23 in 5 years for adults aged 19 to 64 years with immunocompromising conditions
	Added the concept of revaccinating adults ≥65 years who had received a dose of PPSV23 at an age <65 as long as 5 years have elapsed since the first vaccination
2010	PPSV23 recommended for adults aged 19 to 64 years who have asthma smoke cigarettes	6
	PPSV23 no longer recommended for Alaskan Natives or American Indians unless another indication for PPSV23 is present
2012	PCV13 recommended in series with PPSV23 for high-risk adults aged ≥19 years (those with immunocompromising conditions, functional or anatomic asplenia, CSF leaks, or cochlear implants) Pneumococcal vaccine–naïve persons should receive PCV13 first, followed by PPSV23 8 weeks later If previously vaccinated with PPSV23, should receive PCV13 dose ≥1 year after PPSV23 dose No changes to previously recommended doses of PPSV23	9
2014	PCV13 recommended in series with PPSV23 for all adults aged ≥65 years Pneumococcal vaccine–naïve persons should receive PCV13 first, followed by PPSV23 6 to 12 months later If previously vaccinated with PPSV23, give PCV13 ≥1 year after receipt of the most recent PPSV23 dose	11
2015	Changes to recommended intervals between PCV13 and PPSV23 1-year interval recommended between PCV13 and PPSV23, regardless of which vaccine given first, for immunocompetent adults aged ≥65	12

↵* Numerical references relate to the numerical references at the end of the manuscript.
ACIP, Advisory Committee on Immunization Practices; CSF, cerebrospinal fluid; PCV13, 13-valent pneumococcal conjugate vaccine; PPSV23, 23-valent pneumococcal polysaccharide vaccine.