Summary of recommended intervals, for persons with indications to receive PCV13 and PPSV23 sequence

Summary of recommended intervals, by risk and age groups, for persons with indications to receive PCV13 and PPSV23 sequence — Advisory Committee on Immunization Practices, United States

Risk group/underlying medical condition	Intervals for PCV13-PPSV23 sequence, by age group				Intervals for PPSV23-PCV13 sequence, by age group
	24 to 71 months	6 to 18 years	19 to 64 years	≥65 years	24 to 71 months	6 to 18 years	19 to 64 years	≥65 years
No underlying chronic conditions	NA	NA	NA	≥1 year	NA	NA	NA	≥1 year
Immunocompetent persons Chronic heart disease Chronic lung disease Diabetes mellitus Alcoholism* Chronic liver disease, cirrhosis* Cigarette smoking*	≥8 weeks	NA	NA	≥1 year	≥8 weeks	NA	NA	≥1 year
Immunocompetent persons Cerebrospinal fluid leak Cochlear implant	≥8 weeks	≥8 weeks	≥8 weeks	≥8 weeks	≥8 weeks	≥8 weeks	≥1 year	≥1 year
Persons with functional or anatomic asplenia Sickle cell disease/other hemoglobinopathy Congenital or acquired asplenia	≥8 weeks	≥8 weeks	≥8 weeks	≥8 weeks	≥8 weeks	≥8 weeks	≥1 year	≥1 year
Immunocompromised persons Congenital or acquired immunodeficiency Human immunodeficiency virus infection Chronic renal failure Nephrotic syndrome Leukemia Lymphoma Hodgkin disease Generalized malignancy Iatrogenic immunosuppression Solid organ transplant Multiple myeloma*	≥8 weeks	≥8 weeks	≥8 weeks	≥8 weeks	≥8 weeks	≥8 weeks	≥1 year	≥1 year

NA: not applicable; sequential use of PCV13 and PPSV23 is not recommended for these age and risk groups.
* Underlying medical conditions that are not included in the recommendations for children aged <6 years.

Reproduced from: Kobayashi M, Bennett NM, Gierke R, et al. Intervals between PCV13 and PPSV23 vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 2015; 64:944.