50岁起就该打肺炎球菌疫苗：疾控中心说没打过结合疫苗的人可选PCV15、PCV20或PCV21
美国疾病控制与预防中心（CDC）现在的建议是，肺炎球菌疫苗的年龄门槛已经降到50岁：所有50岁以上、从没打过肺炎球菌结合疫苗，或者接种史不清楚的人，都应该打一针结合疫苗，可选的有 PCV15、PCV20 和 PCV21 三种。肺炎球菌能引起的疾病包括肺炎、血流感染和脑膜炎，年纪越大风险越高，这也是年龄一到就建议接种的原因。
三种疫苗的打法不一样，选之前要听医生的。选 PCV15 的，一年后还要再补一针多糖疫苗 PPSV23，补完才算完成，只打一针 PPSV23 就够，不用重复；有免疫功能受损、装了人工耳蜗或有脑脊液漏的人，最短间隔可以缩到8周。选 PCV20 或 PCV21 的，打完这一针就完成了，不需要再补 PPSV23。
年轻时打过老疫苗的人另有安排。65岁以上、以前打过 PCV13（且没打过 PCV15、PCV20、PCV21），并在65岁之后打过 PPSV23 的人，可以和医生共同商量决定，再打一针 PCV20 或 PCV21，或者就此不再追加。自己记不清打过什么也没关系，CDC 免费提供 PneumoRecs VaxAdvisor 工具，手机应用和网页版都有，输入年龄和接种史就能给出个人化的建议。
CDC 同时提醒，5岁以下儿童是另一个常规接种人群，19到49岁有特定健康风险的人也可能需要接种，具体要问自己的医生或药师。秋冬是呼吸道疾病的高发季，50岁以上的读者去打流感疫苗时，可以顺便把肺炎球菌疫苗的接种史一起核对一遍。（来源：美国疾病控制与预防中心）
Pneumococcal Vaccination Starts at 50: CDC Recommends PCV15, PCV20 or PCV21 for Adults Who Have Never Had a Conjugate Vaccine
The Centers for Disease Control and Prevention (CDC) now sets the age for pneumococcal vaccination at 50: every adult age 50 or older who has never received a pneumococcal conjugate vaccine, or whose vaccination history is unknown, should receive one, choosing among PCV15, PCV20 and PCV21. Pneumococcal bacteria can cause pneumonia, bloodstream infections and meningitis, and the risk rises with age, which is why the recommendation is tied to a birthday rather than to illness.
The three vaccines do not finish the job the same way. With PCV15, a dose of the polysaccharide vaccine PPSV23 follows one year later, and only one PPSV23 dose is indicated; for adults with an immunocompromising condition, a cochlear implant or a cerebrospinal fluid leak, the minimum interval can be shortened to 8 weeks. With PCV20 or PCV21, no PPSV23 dose is indicated and the patient's pneumococcal vaccination is complete after that single shot.
People vaccinated under the older schedule have their own option. Adults 65 or older who previously received PCV13, but not PCV15, PCV20 or PCV21, and who received PPSV23 at or after age 65, can decide together with their provider, under shared clinical decision-making, whether to add PCV20 or PCV21 or to get no additional pneumococcal vaccines. For anyone unsure of their history, CDC offers PneumoRecs VaxAdvisor as a free app for iOS and Android, with a web version, that turns an age and vaccination history into patient-specific guidance.
CDC also recommends pneumococcal vaccination for children younger than 5 years, and for children and adults at increased risk, including some adults ages 19 through 49 with certain conditions, who should ask their own provider. With respiratory season under way, adults over 50 who are getting a flu shot can use the same visit to check whether their pneumococcal vaccination is complete. (Source: Centers for Disease Control and Prevention)
来源：美国疾病控制与预防中心
发布：GSM·美国（发布链接）
图片来源：Wikimedia Commons 摄影，公共领域：医护人员为成人接种疫苗（美国国家癌症研究所档案照片）
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