MMWR Recomm Rep. 2023 Sep 8;72(3):1-39. doi: 10.15585/mmwr.rr7203a1.
THIS REPORT COMPILES AND SUMMARIZES ALL PUBLISHED RECOMMENDATIONS FROM CDC’S ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES (ACIP) FOR USE OF PNEUMOCOCCAL VACCINES IN ADULTS AGED ≥19 YEARS IN THE UNITED STATES. THIS REPORT ALSO INCLUDES UPDATED AND NEW CLINICAL GUIDANCE FOR IMPLEMENTATION FROM CDC:
BEFORE 2021, ACIP RECOMMENDED 23-VALENT PNEUMOCOCCAL POLYSACCHARIDE VACCINE (PPSV23) ALONE (UP TO 2 DOSES), OR BOTH A SINGLE DOSE OF 13-VALENT PNEUMOCOCCAL CONJUGATE VACCINE (PCV13) IN COMBINATION WITH 1–3 DOSES OF PPSV23 IN SERIES (PCV13 FOLLOWED BY PPSV23), FOR USE IN U.S. ADULTS DEPENDING ON AGE AND UNDERLYING RISK FOR PNEUMOCOCCAL DISEASE. IN 2021, TWO NEW PNEUMOCOCCAL CONJUGATE VACCINES (PCVS), A 15-VALENT AND A 20-VALENT PCV (PCV15 AND PCV20), WERE LICENSED FOR USE IN U.S. ADULTS AGED ≥18 YEARS BY THE FOOD AND DRUG ADMINISTRATION:
ACIP RECOMMENDATIONS SPECIFY THE USE OF EITHER PCV20 ALONE OR PCV15 IN SERIES WITH PPSV23 FOR ALL ADULTS AGED ≥65 YEARS AND FOR ADULTS AGED 19–64 YEARS WITH CERTAIN UNDERLYING MEDICAL CONDITIONS OR OTHER RISK FACTORS WHO HAVE NOT RECEIVED A PCV OR WHOSE VACCINATION HISTORY IS UNKNOWN. IN ADDITION, ACIP RECOMMENDS USE OF EITHER A SINGLE DOSE OF PCV20 OR ≥1 DOSE OF PPSV23 FOR ADULTS WHO HAVE STARTED THEIR PNEUMOCOCCAL VACCINE SERIES WITH PCV13 BUT HAVE NOT RECEIVED ALL RECOMMENDED PPSV23 DOSES. SHARED CLINICAL DECISION-MAKING IS RECOMMENDED REGARDING USE OF A SUPPLEMENTAL PCV20 DOSE FOR ADULTS AGED ≥65 YEARS WHO HAVE COMPLETED THEIR RECOMMENDED VACCINE SERIES WITH BOTH PCV13 AND PPSV23:
UPDATED AND NEW CLINICAL GUIDANCE FOR IMPLEMENTATION FROM CDC INCLUDES THE RECOMMENDATION FOR USE OF PCV15 OR PCV20 FOR ADULTS WHO HAVE RECEIVED PPSV23 BUT HAVE NOT RECEIVED ANY PCV DOSE. THE REPORT ALSO INCLUDES CLINICAL GUIDANCE FOR ADULTS WHO HAVE RECEIVED 7-VALENT PCV (PCV7) ONLY AND ADULTS WHO ARE HEMATOPOIETIC STEM CELL TRANSPLANT RECIPIENTS:
本报告编译并总结了美国疾病控制与预防中心免疫实践咨询委员会（ACIP）针对≥19 岁成年人使用肺炎球菌疫苗的所有已发布建议。本报告还包括疾病预防控制中心更新和新增的实施临床指南：
在 2021 年之前，ACIP 建议使用 23 价肺炎球菌多糖疫苗（PPSV23）（最多 2 剂），或在同一系列中同时使用 13 价肺炎球菌结合疫苗（PCV13）和 1-3 剂 PPSV23（PCV13 后接 PPSV23），用于美国成年人，具体取决于年龄和肺炎球菌疾病的潜在风险。2021 年，食品和药物管理局批准了两种新的肺炎球菌结合疫苗（PCV），即 15 价和 20 价 PCV（PCV15 和 PCV20），供≥18 岁的美国成年人使用：
ACIP 建议对于所有≥65 岁的成年人以及患有某些潜在医疗条件或其他风险因素但尚未接种 PCV 或疫苗接种史未知的 19-64 岁成年人，使用 PCV20 单独使用或与 PPSV23 联合使用。此外，ACIP 建议对于已开始使用 PCV13 接种肺炎球菌疫苗系列但尚未接种所有推荐 PPSV23 剂量的成年人，使用 PCV20 单剂或≥1 剂 PPSV23。对于已完成 PCV13 和 PPSV23 推荐疫苗系列接种的≥65 岁成年人，建议使用补充 PCV20 剂量，这需要进行共同的临床决策。
疾病预防控制中心的更新和新增实施临床指南包括对已接种 PPSV23 但未接种任何 PCV 剂量的成年人使用 PCV15 或 PCV20 的建议。本报告还包括对仅接种过 7 价肺炎球菌结合疫苗（PCV7）和造血干细胞移植受者的成年人的临床指导。
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