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HCP · Clinical FAQ · Egypt

Pneumococcal

FAQ

Pneumococcal conjugate and polysaccharide vaccines by age and risk.

Content added: NOVEMBER 29, 2025

Last updated: JUNE 04, 2026

The following Frequently Asked Questions (FAQs) are adapted from the recommendations of the Advisory Committee on Immunization Practices (ACIP), Centers for Disease Control and Prevention (CDC), and have been tailored to align with the vaccination schedule and practices in Egypt.

84 questions — use search or expand items below. Content is in English (LTR).

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Q1What causes pneumococcal disease?▾

Q2How does pneumococcal disease spread?▾

Q3What are the types of invasive pneumococcal disease?▾

Q4What is pneumococcal serotype 4 and when might it be considered when selecting a pneumococcal vaccine product for adults?▾

Q5What are the differences between polysaccharide and conjugate vaccines?▾

Q6What are the main differences between pneumococcal polysaccharide vaccine (PPSV23) and the pneumococcal conjugate vaccines (PCVs)?▾

Q7How effective are pneumococcal conjugate vaccines at preventing pneumococcal carriage or disease?▾

Q8How effective is pneumococcal polysaccharide vaccine at preventing pneumococcal carriage or disease?▾

Q9What are the different serotypes of S. pneumoniae targeted by different pneumococcal vaccines?▾

Q10When were the first conjugate vaccines licensed for children?▾

Q11Why are PCV vaccines recommended to be given first when a patient is getting both a PCV and PPSV23 vaccines? Wouldn't PPSV23 protect them against additional strains of the pneumococcal bacteria?▾

Q12Which underlying medical conditions indicate that a child age 6 through 18 years should receive additional doses of pneumococcal vaccine beyond the routine schedule?▾

Q13What are the major changes in the ACIP recommendations for pneumococcal vaccination of children published by CDC on September 29, 2023?▾

Q14How do we account for the history of PCV7 vaccination when determining the pneumococcal vaccination needs of an older teen or young adult with a high-risk condition?▾

Q15When is pneumococcal polysaccharide vaccine (PPSV23) recommended as an option for children?▾

Q16ACIP recommends pneumococcal vaccination for adult cigarette smokers age 19 through 49 years. Should we also vaccinate 16-year-olds who smoke?▾

Q17A 2-month-old was mistakenly given PPSV23 instead of PCV. What should be done?▾

Q19A healthy 4-year-old child in my practice was fully vaccinated on-time with PCV13. Do they need a dose of PCV15 or PCV20?▾

Q20Some children in my practice started the pneumococcal vaccine series with PCV13. Now that PCV15 or PCV20 are recommended, do I need to restart the vaccination series or give additional vaccine doses to all of them?▾

Q21Please describe the recent changes to ACIP recommendations for pneumococcal vaccination of adults?▾

Q22Why did ACIP shift the age for routine pneumococcal conjugate vaccination of all adults from 65 years down to 50 years in October 2024?▾

Q23Will people vaccinated at age 50 need additional doses of pneumococcal conjugate vaccine in the future?▾

Q24What are the categories of medical conditions and other risk factors among adults for which pneumococcal vaccination is recommended? And what is the recommendation?▾

Q25My patient just turned 50 and has never had a pneumococcal vaccine. What are my options now?▾

Q26My patient just turned 50 and had a dose of PPSV23 at age 47 due to alcoholism. What is due now?▾

Q27My patient is 35 and is scheduled for a splenectomy. He has never had a pneumococcal vaccine. What do I do?▾

Q28My patient is currently age 57 and has a history of splenectomy 8 years ago. He has received PCV13 and one dose of PPSV23 in the past. What does he need now?▾

Q29My patient received PCV13 over a year ago and is due for PPSV23, but my clinic only has PCV20. What do I do?▾

Q30My patient is now 70 years old and had PCV13 followed by PPSV23 after he turned 65. What pneumococcal vaccine is due now?▾

Q31My patient is 80 and had a dose of PPSV23 at age 65. He has never had a pneumococcal conjugate vaccine. What is due now?▾

Q32Is PPSV23 alone currently routinely recommended for any adults?▾

Q33I have a patient who takes adalimumab (Humira) for rheumatoid arthritis. Does a person who takes adalimumab meet the definition of immunosuppression for the purposes of pneumococcal vaccination of adults 19-49 years?▾

Q34If a patient has a history of cerebrospinal fluid (CSF) leak but no current leak, is this a risk factor and a reason to administer PCV to an adult?▾

Q35Does an adult younger than age 50 years with beta thalassemia minor meet the criteria for a recommendation for vaccination with a pneumococcal conjugate vaccine?▾

Q36Should adults younger than age 50 with high-risk conditions who have already received PCV13, but not PPSV23, now get one of the newer pneumococcal vaccines?▾

Q38If a vaccination provider stocks only PPSV23, what should that provider do for adults now recommended to receive PCV20 or PCV21 alone or PCV15 followed by PPSV23?▾

Q39There is a debate within my pediatric clinical department about not allowing influenza vaccine to be given with DTaP and pneumococcal conjugate vaccine (PCV). Are there data that state these should not be given concomitantly?▾

Q41We have a 45-year-old patient taking Mesalamine for ulcerative colitis. Should pneumococcal vaccination be recommended for this patient?▾

Q42Can we administer any of the pneumococcal vaccines to patients with multiple sclerosis?▾

Q43Adults who have no spleen need a pneumococcal conjugate vaccination (PCV) and a MenACWY meningococcal vaccine. Do adults need to space out PCV and MenACWY vaccines or can they be given together?▾

Q44Is a patient age 45 years who recently had a prostatectomy with lymph node dissection for prostate cancer a candidate for pneumococcal vaccination? The patient is believed to be cancer-free and is on no chemotherapy.▾

Q45I have patients who are in their 70s and 80s and remember getting a pneumococcal vaccine a few years ago. Should we assume that this was PPSV23? Should I assume that it was given before the 65th birthday?▾

Q46Please explain why people with asthma and people who smoke cigarettes are recommended to be vaccinated against pneumococcal disease?▾

Q47Since pneumococcal vaccination is recommended for all adults who smoke cigarettes, should adults who use smokeless tobacco products (e.g., chewing tobacco) or who vape nicotine be vaccinated too?▾

Q48Is pneumococcal vaccination indicated for former smokers younger than age 50?▾

Q49Does a patient younger than age 50 years who smokes marijuana regularly, but doesn't smoke cigarettes, need to receive pneumococcal vaccination?▾

Q50How did the ACIP recommendation for vaccination of adult smokers too young for routine, age-based pneumococcal vaccination change in 2022?▾

Q51ACIP now recommends PCV20 or PCV21 alone or PCV15 followed by PPSV23 one year later for adults age 19 through 49 with asthma. Should I vaccinate people with mild, intermittent asthma or exercise-induced asthma?▾

Q52Would you include obstructive sleep apnea as chronic pulmonary disease which would require pneumococcal vaccination for adults younger than 50?▾

Q53Should people who are HIV positive receive pneumococcal vaccines?▾

Q54Is systemic lupus erythematosus (SLE, lupus) a risk-based indication for pneumococcal vaccines in adults younger than age 50?▾

Q55How often should adult diabetic patients receive pneumococcal vaccination?▾

Q56How often should adult dialysis patients receive pneumococcal vaccines?▾

Q57My adult patient now has a high-risk condition for which pneumococcal vaccination is recommended. He received the 7-valent pneumococcal conjugate vaccine (PCV7) in childhood but has not had any pneumococcal vaccination as an adult. What do I do?▾

Q58Now that we have PCV15, PCV20, and PCV21, is any adult still recommended to receive multiple doses of PPSV23?▾

Q59We have a patient who has had PCV13 as an adult and is due for PPSV23. Our pharmacy does not have PPSV23 in stock but does have PCV20. Should we send the patient elsewhere?▾

Q60My 43-year-old patient who is about to undergo a splenectomy received PCV15 followed by PPSV23 eight weeks later in preparation for the procedure. When should she get her next dose of PPSV23?▾

Q61Is there any situation when an adult at high risk of invasive pneumococcal disease should receive more than one dose of PPSV23?▾

Q62Does a patient who was vaccinated with PCV13 and one or two doses of PPSV23 before age 65 still need an additional dose of PPSV23 at age 65 or later?▾

Q63Should an 80-year-old patient who was given PPSV23 at age 65 years but has not received any other pneumococcal vaccination be revaccinated with PPSV23?▾

Q64My patient has had laboratory-confirmed pneumococcal pneumonia. Does this patient still need to be vaccinated against pneumococcal disease?▾

Q65If influenza vaccine is recommended for healthcare workers to protect high-risk patients from getting influenza, why aren't the pneumococcal vaccines also recommended?▾

Q66Why should we not give PCV vaccines to someone who has had a serious reaction to a diphtheria-containing vaccine in the past?▾

Q67Why is it always recommended to give PCV15 before giving PPSV23?▾

Q68Can we administer PCV15 and PPSV23 vaccines to a person 50 years of age or older at the same visit? If not, what is the recommended interval between doses?▾

Q69What dosing intervals should be observed when giving PCV15 and PPSV23 to high-risk children who are recommended to receive either PCV20 alone or PCV15 followed by PPSV23?▾

Q70One of our team administered PCV15 and PPSV23 at the same visit to a 5-year-old child who is immunocompromised. We know the PPSV23 was supposed to be administered at least 8 weeks later. We are looking for guidance for what to do now.▾

Q71Our patient is a 78-year-old female who received PCV15, then received PPSV23 approximately 10 weeks later. She had not received PPSV23 previously. Is the PPSV23 dose valid, or does it need to be repeated?▾

Q72We have a 68-year-old patient who received PCV15, then received PPSV23 approximately 5 weeks later. She had not received PPSV23 previously. Is the PPSV23 dose valid, or does it need to be repeated?▾

Q73We have a healthy 66-year-old patient who received a dose of PPSV23 in January then received a dose of PCV15 five months later at a different facility. Should the PCV15 dose be repeated since it was given earlier than the 1-year interval recommended by ACIP?▾

Q74Our 56-year-old patient needs a pneumococcal conjugate vaccine (PCV) today, but we only stock PPSV23. Should we give him PPSV23 today and tell him to return in a year for PCV?▾

Q75If patients 19 through 49 years who are in a recommended risk group for pneumococcal vaccination aren't sure if they have previously been vaccinated with a pneumococcal vaccine, should healthcare providers vaccinate them?▾

Q76We gave PPSV23 to a 66-year-old patient who is newly diagnosed with a medical condition that places him at increased risk for pneumococcal disease and its complications. Should we give him a second dose in 5 years because of his underlying medical condition?▾

Q77When should I vaccinate children or adults who are planning to have either a cochlear implant or elective splenectomy?▾

Q78How should we determine what pneumococcal vaccine(s) are needed for our high-risk pediatric patients?▾

Q79Some physicians in our area order PPSV23 every 5 years for their patients. Is this correct?▾

Q80Can we vaccinate a 2-year-old child with functional or anatomic asplenia against meningococcal disease if he has not completed a series of PCV13?▾

Q82The pneumococcal conjugate vaccine (PCV20) package insert says that in adults, antibody responses to Prevnar 13 (Pfizer) were diminished when given with inactivated influenza vaccine. Does this mean we should not give PCV20 and influenza vaccine at the same visit?▾

Q83A dose of pneumococcal conjugate vaccine was administered into my patient's dialysis port. Does this dose count?▾

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