How often should adult dialysis patients receive pneumococcal vaccines?

Recommendations for adult dialysis patients vary by age and pneumococcal conjugate (PCV) or polysaccharide (PPSV23) vaccination history:

• Adult dialysis patients who have not previously received pneumococcal vaccination should receive either PCV20 or PCV21 alone or a series of PCV15 followed by PPSV23 at least 8 weeks later. No further pneumococcal vaccines are recommended.
• Adult dialysis patients who are age 19 through 64 and have already received one dose of PPSV23 may receive one dose of any currently recommended PCV (PCV15, PCV20, or PCV21) one year after the dose of PPSV23; no further doses of PPSV23 are recommended.
• Adult dialysis patients turning 65 who received PCV13 and PPSV23 before age 65, should receive one dose of PCV20, PCV21, or PPSV23. PCV20 or PCV21 should be given at least 5 years after the last pneumococcal vaccination. If PPSV23 is used, it should be given at least 5 years after the last dose of PPSV23 and at least 8 weeks after PCV13.
• Adult dialysis patients who have already received PCV13 and have received a PPSV23 vaccination since turning 65 are not routinely recommended to receive any additional doses of pneumococcal vaccine. They have the option to receive a dose of PCV20 or PCV21 at least 5 years after their most recent pneumococcal vaccination on the basis of shared clinical decision-making, based upon their risk of pneumococcal disease and desire for additional protection.