My patient is 35 and is scheduled for a splenectomy. He has never had a pneumococcal vaccine. What do I do?

The patient should be vaccinated at least 2 weeks before the splenectomy, if feasible. If not, vaccinate as soon as possible. Depending upon products available, he has three options:

• One dose of PCV20 or PCV21 alone, or
• One dose of PCV15 followed by a dose of PPSV23

CDC recommends that if using the PCV15 and PPSV23 series, a minimum interval of 8 weeks can be considered for adults with an immunocompromising condition (including splenectomy), cochlear implant, or cerebrospinal fluid leak.