Underlying Medical Conditions That Are Indications for Pneumococcal Immunization Among Children, by Risk Groupa and Recommended Vaccines

Risk GroupConditionPCV13PPSV23
RecommendedMay Be Considered1 DoseRepeat Doseb
Immunocompetent childrenChronic heart diseasecXX
Chronic lung diseasedXX
Diabetes mellitusXX
CSF leaksXX
Cochlear implantXX
Children with functional or anatomic aspleniaSickle cell disease and other hemoglobinopathiesXXX
Congenital or acquired asplenia or splenic dysfunctionXXX
Children with immunocompromising conditionsHIV infectionXXX
Chronic renal failure and nephrotic syndromeXXX
Diseases associated with treatment with immunosuppressive drugs or radiation therapy, including malignant neoplasms, leukemias, lymphomas, and Hodgkin disease; or solid organ transplantationXXX
Congenital immunodeficiencyeXXX
  • a Centers for Disease Control and Prevention. Licensure of a 13-valent pneumococcal conjugate vaccine (PCV13) and recommendations for use among children. Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2010;59(9):258–261.

  • b Repeat PPSV23 doses should be 5 y after the first dose.

  • c Particularly cyanotic congenital heart disease and cardiac failure.

  • d Including asthma, if treated with prolonged high-dose oral corticosteroids.

  • e Includes B- (humoral) or T-lymphocyte deficiency; complement deficiencies, particularly C1, C2, C3, and C4 deficiency; and phagocytic disorders (excluding chronic granulomatous disease).