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

Pneumococcal vaccination is recommended for infants and children, Aboriginal and Torres Strait Islander adults aged ≥25 years, adults aged ≥65 years and people with certain risk conditions.

These flowcharts show the recommendations for vaccinating people who have previously received a pneumococcal vaccine:

• Adults
  • Adults aged ≥18 years with risk conditions for pneumococcal disease
  • Aboriginal and Torres Strait Islander adults aged ≥25 years
  • All other adults aged ≥65 years
• Children and adolescents aged ≥12 months to <18 years with risk conditions for pneumococcal disease and Aboriginal and Torres Strait Islander children in the Northern Territory , Queensland, Western Australia and South Australia who have completed their age-appropriate pneumococcal conjugate vaccine (PCV) schedule with only 13-valent PCV (13vPCV) or 15-valent PCV (15vPCV).

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 GP records. If previous vaccination cannot be confirmed, assume that the person has not received the vaccine(s) they need.

There are currently 3 PCVs available in Australia:

• 20-valent PCV (20vPCV), also known as Prevenar 20
• 21-valent PCV (21vPCV), also known as Capvaxive
• 15vPCV, also known as Vaxneuvance.

20vPCV and 15vPCV are registered for use from 6 weeks of age. 20vPCV is funded under the National Immunisation Program (NIP) for children and adolescents aged 18 years and under. 21vPCV is funded under the National Immunisation Program for people aged 18 years and over. 15vPCV is not funded under the National Immunisation Program.

See the Australian Immunisation Handbook for more details.

Adults

Recommended schedule: 1 dose of 21vPCV is recommended in the following adult populations regardless of previous pneumococcal vaccine history:

• Adults aged ≥18 years with risk conditions for pneumococcal disease (including those who were diagnosed before age 18 years and have not yet received a dose of 21vPCV)
• Aboriginal and Torres Strait Islander adults aged ≥25 years
• All other adults aged ≥65 years

Exceptions:

• Adults with a risk condition who received a dose of 21vPCV before their age-based recommendation do not require an additional dose of 21vPCV. For example, an Aboriginal person diagnosed with a risk condition at age 20 years and received a dose of 21vPCV does not require another dose of 21vPCV at age 25 years.
• Aboriginal and Torres Strait Islander adults aged ≥25 years and non-Indigenous adults aged ≥65 years who have already received a dose of 21vPCV do not require an additional dose of 21vPCV if they are subsequently diagnosed with a risk condition.
• Adults who have received a haematopoietic stem cell transplant are recommended to be revaccinated against pneumococcal disease, regardless of previous doses. See Table. Recommendations for vaccination after haematopoietic stem cell transplant in children and adults.

People with no previous dose are recommended to have 1 dose of 21vPCV as soon as possible.

1 dose of 21vPCV is recommended 12 months after the last dose of pneumococcal vaccine for the following groups:

• a person who has previously received 1 dose of 23vPPV
• a person who has previously received 2 or more doses of 23vPPV
• a person who has previously received a dose of 13vPCV, 15vPCV or 20vPCV
• a person who has previously received a dose of 13vPCV, 15vPCV or 20vPCV and 1 dose of 23vPPV
• a person who has previously received a dose of 13vPCV, 15vPCV or 20vPCV and 2 or more doses of 23vPPV.

Children and adolescents aged ≥12 months to <18 years with risk conditions for pneumococcal disease and Aboriginal and Torres Strait Islander children in the Northern Territory, Queensland, Western Australia and South Australia who have completed their age-appropriate PCV schedule with only 13vPCV or 15vPCV

Recommended schedule: 1 dose of 20vPCV.

Exceptions:

• Aboriginal and Torres Strait Islander children 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.
• Children who have received a haematopoietic stem cell transplant are recommended to be revaccinated against pneumococcal disease, regardless of previous doses. See Table. Recommendations for vaccination 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.

People who have not received a previous dose or the childhood schedule of 3 doses of PCV should receive 1 dose of 20vPCV at least 2 months after any previous dose of PCV.

If a person has previously received a dose of 13vPCV or 15vPCV (not including doses received as scheduled childhood vaccinations) they are recommended 1 dose of 20vPCV at age 4 years, or 12 months after any previous dose of PCV, whichever is later.

If a person has previously received a dose of 13vPCV or 15vPCV (not including doses received as scheduled childhood vaccinations) and 1 dose of 23vPPV, they are recommended 1 dose of 20vPCV 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 or more doses of 23vPPV, then no further doses are needed.

If a person has previous received a dose of 20vPCV (not including doses received as scheduled childhood vaccinations), then no further doses are needed.

If a person has previous received a dose of 20vPCV (not including doses received as scheduled childhood vaccinations) and 1 dose of 23vPPV, then no further doses are needed.