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 13vPCV or 15vPCV (for people aged ≥18 years) at diagnosis (at least 2 months after any previous doses of 13vPCV or 15vPCV)
• 1 dose of 23vPPV 12 months after 13vPCV or 15vPCV (2–12 months later is acceptable) or at 4 years of age whichever is later
• a 2nd dose of 23vPPV at least 5 years later

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 already receive these doses as part of their routine schedule.

Children aged ≤5 years with risk conditions who have not received all the recommended 13vPCV doses should receive doses of 13vPCV according to the catch-up schedule. See Table. Catch-up schedule for 13vPCV 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 risk conditions are recommended to receive 13vPCV or 15vPCV (for people aged ≥18 years) if they have not previously received this recommended dose. This should be followed by 2 doses of 23vPPV.

People who have previously received doses of 23vPPV are recommended to receive the dose of 13vPCV or 15vPCV (for people aged ≥18 years) 12 months after their last 23vPPV dose. If they have already received at least 2 doses of 23vPPV, no further 23vPPV doses are recommended.

There is no preference for either 13vPCV or 15vPCV in people aged ≥18 years. It should be noted that 15vPCV may provide anticipated protection against two additional serotypes, however this improvement is diminished after receiving 23vPPV. People aged <18 years are not eligible to receive 15vPCV.

Aboriginal and Torres Strait Islander adults aged ≥50 years already receive these doses, and they do not need to be repeated. The exception is people who have received a haematopoietic stem cell transplant — these people are recommended to receive 3 doses of 13vPCV or 15vPCV 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 13vPCV or 15vPCV (for people aged 18 years and over) 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^5-8 and this is considered also applicable to 13vPCV. A study in adults infected with HIV also found that 23vPPV elicits a good immune response when given 2 months after a 15vPCV dose.⁹