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Pneumococcal Vaccination — RACP Adult Medicine MCQ

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ModerateRespiratoryPneumococcal VaccinationRACP Adult Medicine

A 70-year-old man with known COPD develops community-acquired pneumonia. He was vaccinated with 13-valent pneumococcal conjugate vaccine (PCV13) 2 years ago. According to the Australian Immunisation Handbook, does he require additional pneumococcal vaccination?

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Correct answer: A — PCV20 now

The Australian Immunisation Handbook (updated 2024) now recommends PCV20 (20-valent conjugate vaccine) as the preferred pneumococcal vaccine for adults with risk conditions including COPD. For those who previously received PCV13, a dose of PCV20 is recommended ≥12 months later. PCV20 provides broader serotype coverage than PCV13 and generates a conjugate (T-cell dependent) immune response, which is superior to the polysaccharide response of 23vPPV. This replaces the previous sequential PCV13 → 23vPPV strategy.

Reference: ATAGI – 2024 – Australian Immunisation Handbook; NCIRS – 2025 – Pneumococcal Vaccines