According to updated recommendations from the Centers for Disease Control and Prevention (CDC)’s Advisory Committee on Immunization Practices (ACIP), the 13-valent pneumococcal conjugate vaccine (PCV13) is no longer recommended for routine use in adults aged ≥65 years. The recommendations have been published in the recent Morbidity and Mortality Weekly Report.

The decision to update the pneumococcal vaccine recommendations was based on a review of evidence that demonstrated that the implementation of the 2014 recommendation had minimal impact on PCV13-type disease at the population level among older adults. As such, ACIP has removed the recommendation for routine use of PCV13 in this population and instead recommends shared clinical decision-making with regard to its use in patients aged ≥65 years who do not have an immunocompromising condition, cerebrospinal fluid leak, or cochlear implant and who have not previously received PCV13.

In their report, the ACIP Pneumococcal Vaccines Work Group provides a list of considerations for shared clinical decision-making regarding PCV13 use in patients ≥65 years. Patients that may be at increased risk for exposure to PCV13 serotypes include those residing in nursing homes, long-term care facilities, or settings with low pediatric PCV13 uptake, as well as those traveling to settings with no pediatric PCV13 program.

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The ACIP continues to recommend that all patients aged ≥65 years receive a dose of 23-valent polysaccharide vaccine (PPSV23). Adults aged ≥65 years who received ≥1 dose of PPSV23 before age 65 years should receive 1 additional dose of PPSV23 at age ≥65 years, at least 5 years after the previous PPSV23 dose. If a decision to administer PCV13 is made, it should be administered at least 1 year before PPSV23; the vaccines should not be coadministered.

“ACIP will continue to review relevant data as they become available and update pneumococcal vaccination policy as appropriate,” the panel stated in the report.

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