Table 1. Indications for Pneumococcal Polysaccharide Vaccine (PPV23)
Who needs to be vaccinated with PPV23?

  1. Vaccinate all previously unvaccinated adults aged 65 years and older.

  2. Vaccinate all adults who smoke cigarettes.

  3. Vaccinate persons aged 2 to 64 years who:

    • have chronic cardiovascular disease (eg, congestive heart failure, cardiomyopathy); chronic pulmonary disease (eg, chronic obstructive pulmonary disease, emphysema, adults with asthma); or diabetes mellitus or those who are cochlear implant patients.

    • have chronic liver disease (including cirrhosis), are alcoholic, or have a cerebrospinal fluid leak.

    • live in special environments or social settings (eg, adults aged 50 to 64 years who are Alaska Natives or certain American Indian populations if recommended by local health authorities).

  4. Vaccinate persons aged 2 to 64 years with functional or anatomic asplenia (including persons with sickle cell disease or splenectomy patients).

  5. Vaccinate immunocompromised persons aged 2 years and older, including those with HIV infection,* leukemia, lymphoma, Hodgkin disease, multiple myeloma, generalized malignancy, chronic renal failure (including dialysis patients), or nephrotic syndrome; those receiving immunosuppressive therapy (including long-term systemic corticosteroids); and those who have received an organ or bone marrow transplant.†

Who needs a second dose of PPV23?A one-time revaccination is indicated for:

  • All adults aged 65 years and older who were previously vaccinated with PPSV before age 65 if ≥5 years have elapsed since the previous dose.

  • All children and adults who are at the highest risk of serious pneumococcal disease or are likely to have a rapid decline in pneumococcal antibody levels (categories 4 and 5 above) if ≥5 years have elapsed since the previous dose.

  • ↵* Persons with asymptomatic or symptomatic HIV infection should be vaccinated as soon as possible after their diagnosis is confirmed (per Prevention of pneumococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 1997;46(RR-8):1–24).

  • ↵† When cancer chemotherapy or other immunosuppressive therapy is being considered (eg, for patients with Hodgkin disease or those who undergo organ or bone marrow transplantation), PPV23 should be given 2 weeks before or 3 months after immunosuppressive or radiation therapy. Vaccination during chemotherapy or radiation therapy should be avoided (per Prevention of pneumococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 1997;46(RR-8):1–24).

  • Adapted with permission from Pneumococcal polysaccharide vaccine (PPSV) CDC answers your questions. From the Immunization Action Coalition, St. Paul, MN. Available online at: www.immunize.org/catg.d/p2015.pdf.