In patients age 19-64 with a high risk condition (see CDC site below), ACIP has long recommended they receive PCV 23, followed by a 2nd dose 5 years later. PCV 23 is also recommended as a one-time dose for all patients age 65 and over. Now the CDC is recommending, for patients age 19-64 with a high risk conditions, a dose of PCV 13, followed by PCV 23 at least 8 weeks later. For those high risk and in this age group who have already received PCV 23, they should also receive PCV 13 at least 1 year after their dose of PCV 23. Full recommendations are available at the CDC site (CDC site)
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