My 43-year-old patient who is about to undergo a splenectomy received PCV15 followed by PPSV23 eight weeks later in preparation for the procedure. When should she get her next dose of PPSV23?

At this time, ACIP does not recommend revaccination with a second dose of PPSV23 for adults younger than 65 with asplenia who receive PCV15 (Vaxneuvance, Merck) followed by PPSV23.

If the adult patient with asplenia had received PCV13 (Prevnar 13, Pfizer) followed by PPSV23 (instead of Vaxneuvance), then CDC recommends one of two vaccine schedules:

• Option 1: Administer a dose of PCV20 or PCV21 at least 5 years after the dose of PPSV23. No further doses of pneumococcal vaccine are recommended.
• Option 2: Administer PPSV23 at least 5 years following the first PPSV23 dose. Plan to review CDC recommendations for pneumococcal vaccination at the time the patient turns 65 because additional doses might be recommended at that point.