Revaccination of pneumococcal vaccine

• UK immunisation policy has transitioned from PPV23 to PCV20 for adult and clinical risk group programmes, with PCV20 now replacing PPV23 for revaccination protocols (1)
• pneumococcal vaccines are inactivated, non-live, and thiomersal-free; revaccination is well tolerated, and testing antibody levels prior to vaccination is not required (1)

Infant Routine Schedule

• primary dose: a single priming dose of 0.5 mL PCV13 administered at 16 weeks of age (moved from 12 weeks to allow earlier administration of 4CMenB) (1)
• booster dose: a booster dose of 0.5 mL PCV13 at one year of age (on or after their first birthday) given alongside other routine 12-month immunisations (1)
• note on PCV15: although PCV15 is licensed for use from 6 weeks of age, it is not currently included in the UK national immunisation programme

Re-immunisation and Revaccination Policy

• antibody levels decline rapidly in individuals with asplenia, splenic dysfunction (including sickle cell disease), or chronic kidney disease; therefore, re-immunisation with PCV20 (rather than PPV23) is recommended every 5 years strictly for these groups (1)
• single-dose clinical risk groups: individuals aged 2 years or over in other clinical risk groups receive a single dose of PCV20 and do not require 5-yearly boosters
• severe immunocompromise: individuals aged 2 years or over with severe immunocompromise require 2 doses of PCV20 given 4 weeks apart
• revaccination with PCV20 or PPV23 is currently not recommended for any other clinical risk groups or age groups

Clinical Practice Considerations

• PCV20 implementation: PCV20 replaced PPV23 for at-risk groups and adults turning 65 years; existing local stocks of PPV23 should be used up first
• prior vaccination at age 65: if an individual has already received PCV20 or PPV23 because they are in a clinical risk group, they do not require another dose at 65 years of age, irrespective of the interval since their last dose (1)

Reference:

1. UK Health Security Agency (UKHSA). Pneumococcal: guidance and immunisation schedule. UKHSA Guidance. Updated 16 October 2026.