Routine vaccination with PCV

• 4-dose series at 2, 4, 6, 12–15 months

Catch-up vaccination with PCV

• Healthy children age 24–59 months with any incomplete* PCV series: 1 dose PCV

Special situations

Underlying conditions below: When both PCV and PPSV23 are indicated, administer PCV first. PCV and PPSV23 should not be administered during the same visit. Chronic heart disease (particularly cyanotic congenital heart disease and cardiac failure); chronic lung disease (including asthma treated with high-dose, oral corticosteroids); diabetes mellitus:

Age 2–5 Years

• Any incomplete* series with:
  -3 PCV doses: 1 dose PCV (at least 8 weeks after any prior PCV dose) -Less than 3 PCV doses: 2 doses PCV (8 weeks after the most recent dose and administered 8 weeks apart)

• No history of PPSV23: 1 dose PPSV23 (at least 8 weeks after completing all recommended PCV doses)

Age 6–18 years

• Any incomplete* series with PCV: no further PCV doses needed

• No history of PPSV23: 1 dose PPSV23 (at least 8 weeks after completing all recommended PCV doses)

Cerebrospinal fluid leak, cochlear implant:

Age 2–5 Years

• Any incomplete* series with:
  -3 PCV doses: 1 dose PCV (at least 8 weeks after any prior PCV dose) -Less than 3 PCV doses: 2 doses PCV (8 weeks after the most recent dose and administered 8 weeks apart)

• No history of PPSV23: 1 dose PPSV23 (at least 8 weeks after completing all recommended PCV doses)

Age 6–18 years

• No history of either PCV or PPSV23: 1 dose PCV, 1 dose PPSV23 at least 8 weeks later

• Any PCV but no PPSV23: 1 dose PPSV23 at least 8 weeks after the most recent dose of PCV

• PPSV23 but no PCV: 1 dose PCV at least 8 weeks after the most recent dose of PPSV23

Sickle cell disease and other hemoglobinopathies; anatomic or functional asplenia; congenital or acquired immunodeficiency; HIV infection; chronic renal failure; nephrotic syndrome; malignant neoplasms, leukemias, lymphomas, Hodgkin disease, and other diseases associated with treatment with immunosuppressive drugs or radiation therapy;

solid organ transplantation; multiple myeloma:

Age 2–5 Years

• Any incomplete* series with:
  -3 PCV doses: 1 dose PCV (at least 8 weeks after any prior PCV dose) -Less than 3 PCV doses: 2 doses PCV (8 weeks after the most recent dose and administered 8 weeks apart)

• No history of PPSV23: 1 dose PPSV23 (at least 8 weeks after completing all recommended PCV doses) and a dose 2 of PPSV23 5 years later

Age 6–18 years

• No history of either PCV or PPSV23: 1 dose PCV, 2 doses PPSV23 (dose 1 of PPSV23 administered 8 weeks after PCV and dose 2 of PPSV23 administered at least 5 years after dose 1 of PPSV23)

• Any PCV but no PPSV23: 2 doses PPSV23 (dose 1 of PPSV23 administered 8 weeks after the most recent dose of PCV and dose 2 of PPSV23 administered at least 5 years after dose 1 of PPSV23)

• PPSV23 but no PCV: 1 dose PCV at least 8 weeks after the most recent PPSV23 dose and a dose 2 of PPSV23 administered 5 years after dose 1 of PPSV23 and at least 8 weeks after a dose of PCV

• * Incomplete series = Not having received all doses in either the recommended series or an age-appropriate catch-up series see catch up schedule