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CDC Immunization Committee Recommends 2 Pneumococcal Vaccines for Immunocompromised Adults


People with compromised immune systems, including those with advanced HIV disease, should receive a combination of 2 different vaccines to prevent pneumococcal disease, the CDC's Advisory Committee on Immunization Practices (ACIP) recommended at its meeting last week in Atlanta.

People with HIV/AIDS are susceptible to opportunistic infections once their CD4 T-cell count falls to a low level (below 200, 100, or 50, depending on the infection). Pneumococcal disease, caused by the bacteria Streptococcus pneumoniae (pneumococcus), can cause pneumonia, meningitis, and other illnesses. Immunocompromised people -- including organ transplant recipients, people with certain cancers, and others taking immunosuppressive drugs, as well as people with congenital or acquired immune deficiency -- are more likely to develop severe, invasive disease.

As MedPage Today reported, ACIP panel members voted unanimously to recommend a combination of the 13-valent pneumococcal conjugate vaccine known as Prevnar 13 (PCV13) plus the 23-serotype polysaccharide vaccine known as Pneumovax 23 (PPSV23) for people with compromised immunity.

Evidence indicates that this regimen offers more effective protection for this population, and that its benefits likely outweigh its risks. Data also have shown that the double regimen is cost-effective, especially for people with HIV.

The CDC currently recommends PPSV23 for everyone age 65 or older and for people age 2 to 64 who are at risk for pneumococcal infection due to chronic illness or medical conditions including HIV/AIDS. PCV13 is approved for children age 6 months to 5 years to prevent invasive pneumococcal disease, and for people age 50 or older to prevent pneumococcal pneumonia and invasive disease.

The CDC is not required to adopt advisory committee votes, but it usually does so. Final recommendations -- including number of injections and dose schedules for different age groups -- will be published in Morbidity and Mortality Weekly Reportand made available on the ACIP web site at



CDC. CDC's Advisory Committee on Immunization Practices Meeting. Press release. June 14, 2012.

CDC. Pneumococcal Disease - In Short. Fact sheet. April 1 2011.

T Neale. ACIP: High-Risk Adults Need Two Pneumoncoccal Vaccines. MedPage Today. June 20, 2012.