Recommendations

What Are the National and Global Recommendations for the Use of Pneumococcal Vaccines in Chronic Lung Disease?

Pneumococcal vaccination is recommended for use in patients with chronic lung diseases, including COPD,by various global bodies and respiratory societies, like GOLD (2020), Swiss Respiratory Society (2013), British Columbia Medical Association (2011), CDC’s ACIP (2019), the Portuguese Respiratory Society (2014), the Spanish Society of Pneumology and Thoracic Surgery, the Philippine Society for Microbiology and Infectious Diseases and Royal College of Physicians of Thailand.^1-8

CDC’s ACIP (2019) recommends the use of PCV13 in persons aged ≥65 years with chronic lung diseases based on shared clinical decision-making. One dose of PPSV23 is recommended for persons aged <65 years with chronic lung disease. For persons aged ≥65 years, 1 dose of PPSV23 is recommended; if PCV13 has been administered, then PPSV23 should be given ≥1 year after PCV13 and ≥5 years after any PPSV23 at age <65 years. The Portuguese Respiratory Society (2014) recommended the sequential administration of PCV13 and PPSV23 in adults aged ≥50 years with chronic respiratory diseases, including chronic asthma under inhaled corticosteroid. The Spanish Society of Pneumology and Thoracic Surgery (2013) in a joint consensus document recommended the use of PCV13 in chronic respiratory diseases (including COPD, asthma and interstitial lung disease). The Philippine Society for Microbiology and Infectious Diseases and Royal College of Physicians of Thailand also recommended the use of PCV13 in patients with chronic lung diseases.^7,8

The API (2014) recommended the use of pneumococcal vaccines in adults aged ≥50 years with predisposing conditions, including chronic lung disease. Other national guidelines that recommend the use of pneumococcal vaccines in chronic lung diseases include those from the IAOH (2020), IMA, etc. The IAOH, API and IMA recommend the use of PCV13 and PPSV23 in high-risk adults aged between 50 and 64 years. The high-risk group of adults includes patients with COPD. In these cases, PCV13 should be administered first followed by PPSV23 after 8 weeks. Thereafter, PPSV23 can be repeated after 5 years.^9-11

ACIP, Advisory Committee on Immunization practices; API, Association of Physicians of India; CDC, Centers for Disease Control and Prevention; COPD, chronic obstructive pulmonary disease; GOLD, Global Initiative for Chronic Obstructive Lung Disease; IMA, Indian Medical Association; IAOH, Indian Association of Occupational Health; PCV13, 13-valent pneumococcal conjugate vaccine; PPSV23, 23-valent pneumococcal plain polysaccharide vaccine.

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