eTable 33-9.

Recommendations for PPSV23 and PCV13 by Risk Group for Adults 19 Years and Older^*

Risk Group	PCV13 Recommended	PPSV23 Recommended	PPSV23 Revaccination 5 Years after First Dose
Immunocompetent	Cerebrospinal fluid leak Cochlear implant	Chronic heart diseases† Chronic lung diseases‡ Diabetes mellitus Chronic liver diseases Cerebrospinal fluid leak Cochlear implant Alcohol Smoking
Asplenia	Sickle cell disease/ hemoglobinopathy Congenital or acquired asplenia	Sickle cell disease/ hemoglobinopathy Congenital or acquired asplenia	Sickle cell disease/ hemoglobinopathy Congenital or acquired asplenia
Immunocompromised	HIV Congenital or acquired immunodeficiency Chronic renal failure Leukemia/lymphoma Generalized malignancy Solid organ transplant Multiple myeloma Iatrogenic immunosuppression§	HIV Congenital or acquired immunodeficiency Chronic renal failure Leukemia/lymphoma Generalized malignancy Solid organ transplant Multiple myeloma Iatrogenic immunosuppression	HIV Congenital or acquired immunodeficiency Chronic renal failure Leukemia/lymphoma Generalized malignancy Solid organ transplant Multiple myeloma Iatrogenic immunosuppression

^*All adults aged 65 years and older should receive PVC13 and PPSV23, with the sequence and interval depending on previous history of vaccination with pneumococcal vaccine.

^†Including congestive heart failure and cardiomyopathies.

^‡COPD, emphysema, and asthma.

^§Including long-term systemic corticosteroids and radiation therapy.

Modified from Centers for Disease Control and Prevention: Tomczyk S, Bennett NM, Stoecker C, et al: Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among adults aged ≥ 65 years: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 63(37):822–825, 2014.