Recommendations

What Are the National and Global Recommendations for Pneumococcal Vaccination in HIV-infected Adults?

Various global and national guidelines have specific recommendations for pneumococcal vaccines in HIV-infected individuals. The ACIP 2019 guidelines recommend the use of PCV13 and PPSV23 in all HIV-infected adults aged ≥50 years; 1 dose of PCV13 and 2 doses of PPSV23 (1st dose ≥8 weeks after PCV13, and 2nd dose ≥5 years after first PPSV23 dose) in adults aged 50 to 64 years. In adults aged ≥65 years, 1 dose of PCV13 is recommended if not previously vaccinated, and 1 dose of PPSV13 should be given ≥8 weeks after PCV13 and ≥5 years after any PPSV23 received at an age <65 years.¹

The IAOH recommends the use of PCV13 and PPSV23 in series in all HIV-infected adults aged ≥50 years; 1 dose of PCV13 should be administered first followed by 1 dose of PPSV23 at least 1 year after receiving PCV13.² The IMA (2018) recommends the use of PCV13 in adults aged ≥50 years when diagnosed with HIV. A maximum 3 doses of PPSV23 can be administered to these adults, with a minimum gap of 5 years; the first PPSV23 dose should be administered with a minimum gap of ≥8 weeks from PCV13 administration, second dose a minimum of 5 years after that and the third dose should be administered at the age of ≥65 years.³

ACIP, Advisory Committee on Immunization Practices; HIV, human immunodeficiency virus; IAOH, Indian Association of Occupational Health; IMA, Indian Medical Association; PCV13, 13-valent pneumococcal conjugate vaccine; PPSV23, 23-valent pneumococcal plain polysaccharide vaccine.

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