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The U.S. Centers for Disease Control and Prevention protocols for pneumococcal vaccination in adults were tweaked yet again in 2022 to accommodate two new conjugate vaccines. A 15-valent option (PCV15; Vaxneuvance) and a 20-valent option (PCV20; Prevnar-20) have replaced the old 13-valent option (PCV13; Prevnar-13). The two new conjugate vaccines join the venerable 23-valent polysaccharide Pneumovax (PPSV23) to broaden overall serotype coverage — and also, perhaps, overall confusion (NEJM JW Gen Med Mar 15 2022 and MMWR Morb Mortal Wkly Rep 2022; 71:109; NEJM JW Gen Med Mar 15 2022 and Ann Intern Med 2022; 175:432).
Two new algorithms apply to all adults older than 65, as well as all younger adults (age range, 18–64) who are at high risk for…