Abstract
INTRODUCTION: Streptococcus pneumoniae is a common cause of bacterial pneumonia, bacteraemia and meningitis in adults, especially among older adults and individuals with specific underlying medical conditions. The composition of the capsular polysaccharides distinguishes different pneumococcal serotypes and serves as the target for commercially available vaccines. The 20-valent pneumococcal conjugate vaccine (PCV20) was introduced in 2021, conferring protection to seven additional serotypes over PCV13 and five over PCV15, and, thus, providing increased coverage against common serotypes that cause invasive pneumococcal disease (IPD) and community-acquired pneumonia. The present narrative review summarises current recommendations for pneumococcal vaccination in different countries, focusing on adult and at-risk populations, safety, tolerability, and cost-effectiveness. METHODS: A comprehensive search of existing literature was conducted on PubMed, Scopus and government websites to gather relevant articles, studies and recommendations about PCV20. The information was summarised to provide an overview. RESULTS: The recommendations for adults over 65 years of age support the use of a single dose of PCV20, and a single booster of PCV20 for people who had previously received PCV13 or PPSV23. The administration of PCV20 is also recommended for those who have not completed the vaccine schedules for PCV13 or PPSV23. Several countries have recently included PCV20 in the vaccination of adults and children at higher risk of developing IPD. CONCLUSION: The efficacy, safety and cost-effectiveness of PCV20 support its use in preventing invasive and noninvasive pneumococcal disease across age groups, including those with underlying health conditions.