In consideration of new data and the availability of an additional vaccine for adults, the German Standing Committee on Vaccination (STIKO) has updated its recommendation for the routine vaccination of older adults against pneumococcal diseases.
Updated recommendation
Routine vaccination is recommended for all adults from the age of 60 years. Vaccination shall be given with a vaccine of the greatest possible efficacy against the pneumococcal serotypes currently causing disease in the target group; this is currently the 23-valent polysaccharide vaccine (PPSV23).
In principle, because of the limited duration of protection provided by the vaccine, STIKO considers repeated vaccinations with PPSV23 useful from a medico-epidemiological perspective. The current prescribing information specifies that “healthy adults should not routinely be re-vaccinated”, i. e. routine re-vaccination is not covered by the market authorization.
However, according to the prescribing information “re-vaccination may be considered for persons at increased risk for severe pneumococcal disease”. In this case STIKO recommends a minimum interval of 6 years between vaccine doses.
Seniors who belong to one of the risk groups listed in table 2 of the STIKO recommendations because of a chronic condition (category “I”) or because of occupational exposure (category “B”) should be vaccinated according to the specific recommendations for these groups.
Seniors who have already been vaccinated with the 13-valent conjugate vaccine (PCV13) should receive a follow-up vaccination with PPSV23 6–12 months after PCV13 to expand serotype coverage.
The objective of the vaccination recommendation is to reduce the number of cases of invasive pneumococcal disease and pneumococcal pneumonia and their consequences, such as hospitalization, disability, and death among older adults in Germany.

Background paper Europe Germany Pneumococcal disease