People aged >12 months with risk conditions are recommended to receive pneumococcal conjugate vaccine and 23vPPV

All children and adults with newly identified risk conditions (see List. Risk conditions for pneumococcal disease) are recommended to receive:

• 1 dose of a pneumococcal conjugate vaccine (13vPCV, 15vPCV or 20vPCV) at diagnosis (at least 2 months after any previous doses of a pneumococcal conjugate vaccine), and
• 1 dose of 23vPPV 12 months after a pneumococcal conjugate vaccine (13vPCV, 15vPCV or 20vPCV) (2–12 months following the last dose of PCV is acceptable), and
• a 2nd dose of 23vPPV at least 5 years after the 1st dose of 23vPPV

Aboriginal and Torres Strait Islander children <5 years of age with risk conditions who live in the Northern Territory, Queensland, South Australia and Western Australia are already recommended to receive these doses as part of their routine schedule. 

Children aged <5 years with risk conditions who have not received all the recommended pneumococcal conjugate vaccine doses should receive doses of a pneumococcal conjugate vaccine according to the catch-up schedule. See Table. Catch-up schedule for pneumococcal conjugate vaccines for Aboriginal and Torres Strait Islander children living in NT, Qld, SA or WA ONLY, and all children with any risk condition(s) for pneumococcal disease, aged <5 years. 

All children and adults with existing risk conditions are recommended to receive a pneumococcal conjugate vaccine if they have not previously received this recommended dose. This dose of conjugate vaccine should be followed by 2 doses of 23vPPV. 

People who have previously received doses of 23vPPV are recommended to receive an age appropriate pneumococcal conjugate vaccine 12 months after their last 23vPPV dose. If they have already received at least 2 doses of 23vPPV, no further 23vPPV doses are recommended.  See Infographic. Pneumococcal vaccination recommendations for people who have previously received a pneumococcal vaccine.

There is no preference for either 13vPCV, 15vPCV or 20vPCV in people aged ≥18 years. For people aged <18 years there is no preference for 13vPCV or 15vPCV. 

20vPCV is anticipated to provide benefit against seven additional serotypes, when compared to 13vPCV, but it is uncertain if this difference is maintained after receiving 23vPPV. It should also be noted that 15vPCV is anticipated to provide benefit against two additional serotypes compared to 13vPCV, however this difference is diminished after receiving 23vPPV.²

Aboriginal and Torres Strait Islander adults aged ≥50 years who have already received these doses do not need the doses repeated. The exception is people who have received a haematopoietic stem cell transplant — these people are recommended to receive 3 doses of a pneumococcal conjugate vaccine after transplantation. See Table. Recommendations for revaccination after haematopoietic stem cell transplant in children and adults.

A minimum interval of 2 months between the last dose of an age appropriate pneumococcal conjugate vaccine and 23vPPV is recommended. This is based on a small number of studies in children of different ages with underlying conditions. These studies have shown that 23vPPV elicits a good immune response when given approximately 2 months after a 7vPCV dose^6-9 and this is considered also applicable to other pneumococcal conjugate vaccines. A study in adults infected with HIV also found that 23vPPV elicits a good immune response when given 2 months after a 15vPCV dose.¹⁰

13vPCV (Prevenar 13) and the additional doses of 23vPPV (Pneumovax 23) are both funded through the NIP for people with certain risk conditions. For details see the National Immunisation Program Schedule.