Pneumococcal vaccination recommendations for people who have previously received a pneumococcal vaccine

Several pneumococcal vaccines are available in Australia. 

Pneumococcal vaccination is recommended for infants and children, Aboriginal and Torres Strait Islander adults aged ≥50 years, non-Indigenous adults aged ≥70 years, and people with certain risk conditions. These flowcharts show the recommendations for vaccinating people who have previously received a pneumococcal vaccine, presented as follows: 

• Non-Indigenous adults aged ≥70 years without risk conditions for pneumococcal disease 
• All Aboriginal and Torres Strait Islander adults aged ≥50 years 
• People aged ≥12 months with risk conditions for pneumococcal disease. 

These previous doses do not include the doses received as part of the routine childhood schedule. For information on routine vaccination in children aged <10 years, see the National Immunisation Program Schedule, the Australian Immunisation Handbook and the National Immunisation Catch-up Calculator. 

Providers should verify that any previous doses have been documented, such as in the Australian Immunisation Register (AIR) or in medical records. If previous vaccination cannot be confirmed, assume that the person has not received the vaccine(s) they need.

There are currently four pneumococcal vaccines available in Australia: Three pneumococcal conjugate vaccines (PCVs), which are 13vPCV, 15vPCV, 20vPCV also known as Prevenar 13, Vaxneuvance and Prevenar 20 respectively, and one polysaccharide vaccine 23vPPV also known as Pneumovax 23. The three conjugate vaccines are registered for use from 6 weeks of age and 23vPPV is registered for use from 2 years of age.

Non-Indigenous adults aged ≥70 years without risk conditions for pneumococcal disease

The recommended schedule for this population is 1 dose of PCV as soon as possible. People in this group are no longer recommended to receive any doses of 23vPPV. 

If a person has had 1 or more previous doses of 23vPPV, they are recommended 1 dose of PCV at least 12 months after their dose of 23vPPV.

If a person has had a previous dose of PCV, then no further doses are required.

All Aboriginal and Torres Strait Islander adults aged ≥50 years

The recommended schedule for this population is 1 dose of PCV followed by a dose of 23vPPV, 2 to 12 months later and a second dose of 23vPPV at least 5 years after the first dose of 23vPPV.

If a person has previously received 1 dose of 23vPPV, they are recommended 1 dose of PCV at least 12 months after their dose of 23vPPV and 1 dose of 23vPPV, 2 to 12 months after PCV or 5 years after previous 23vPPV, whichever is later.

If a person has previously received 2 or more doses of 23vPPV, they are recommended to receive 1 dose of PCV at least 12 months after the last 23vPPV.

If a person has previously received a dose of PCV, they are recommended 1 dose of 23vPPV, 2 to 12 months after PCV and a second dose of 23vPPV at least 5 years after the first dose of 23vPPV.

If a person has previously received a dose of PCV and 1 dose of 23vPPV, they are recommended 1 dose of 23vPPV, 2 to 12 months after PCV or 5 years after 23vPPV, whichever is later.

If a person has previously received a dose of PCV and 2 doses of 23vPPV, then no further doses are required.

People aged ≥12 months with risk conditions for pneumococcal disease

The recommended schedule (in addition to the routine childhood schedule) for this population is 1 dose of PCV as soon as possible for people with existing risk conditions OR at diagnosis, followed by a dose of 23vPPV, 2 to 12 months later and a second dose of 23vPPV at least 5 years after the first dose of 23vPPV.

Exceptions: 

• Aboriginal and Torres Strait Islander children living in NT, QLD, SA and WA who are fully vaccinated will have already received the appropriate number of doses regardless of whether they have been diagnosed with a risk condition. No further doses are needed for these children. 
• People who have received a haematopoietic stem cell transplant are recommended to be revaccinated against pneumococcal disease, regardless of previous doses. See Table. Recommendations for revaccination after haematopoietic stem cell transplant in children and adults. 
• Children aged <5 years with risk conditions who have not completed the childhood pneumococcal vaccination schedule should follow the catch-up schedule.

If a person has previously received 1 dose of 23vPPV, they are recommended 1 dose of PCV at least 12 months after their dose of 23vPPV and 1 dose of 23vPPV 2 to 12 months after PCV or 5 years after 23vPPV, whichever is later.

If a person has previously received 2 or more doses of 23vPPV, they are recommended to receive 1 dose of PCV at least 12 months after the last 23vPPV.

If a person has previously received a dose of PCV (not including doses received as scheduled childhood vaccinations), they are recommended 1 dose of 23vPPV, 2 to 12 months after PCV and a second dose of 23vPPV at least 5 years after the first dose of 23vPPV.

If a person has previously received a dose of PCV (not including doses received as scheduled childhood vaccinations) and 1 dose of 23vPPV, they are recommended 1 dose of 23vPPV, 2 to 12 months after PCV or 5 years after 23vPPV, whichever is later.

If a person has previously received a dose of PCV (not including doses received as scheduled childhood vaccinations) and 2 doses of 23vPPV, then no further doses are required.