Incidence of pneumococcal conjugate vaccine (PCV13) type disease has been reduced to historically low levels among adults aged ≥65 years through indirect effects from pediatric PCV13 use. Implementation of a PCV13 recommendation for all adults aged ≥65 years in 2014 has had minimal impact on PCV13 type disease at the population level in this age group.

However, PCV13 is a safe and effective vaccine that can reduce the risk for PCV13 type pneumonia among persons aged ≥65 years. Balancing this evidence and considering acceptability and feasibility concerns, in June 2019 ACIP voted to no longer routinely recommend PCV13 for all adults aged ≥65 years.

Instead, recommendation of PCV13 should be based on shared clinical decision-making for adults aged ≥65 years who do not have an immunocompromising condition, CSF leak, or cochlear implant.

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