Although the 13-valent conjugate pneumococcal vaccine (PCV13) was approved by the United States Food and Drug Administration (FDA) for use in adults ≥50 years of age in December 2011, it has not been recommended by the United States Advisory Committee on Immunization Practices (ACIP) for healthy adults [37]. However, in June 2012, the ACIP voted to recommend PCV13 for use in individuals aged 19 or older with immunocompromising conditions (eg, HIV infection, cancer, functional or anatomic asplenia), cerebrospinal fluid leaks, cochlear implants, or advanced kidney disease [39]. Although the ACIP recommendations have not yet been published, we recommend that individuals who meet the criteria described above receive PCV13 in addition to PPSV23 according to the following schedule [39]:

 

• For patients who have previously received one or more doses of PPSV23, a single dose of PCV13 should be given one or more years after the last PPSV23 dose was received.
• For patients who have not previously received either PCV13 or PPSV23, a single dose of PCV13 should be given, followed by a dose of PPSV23 at least eight weeks later.
• For patients who require additional doses of PPSV23, the first such dose should be given no sooner than eight weeks after PCV13 and at least five years after the most recent dose of PPSV23.