Recommendations for Adult Pneumococcal Vaccination in Korea: 2026 Update Incorporating the 21-Valent Pneumococcal Conjugate Vaccine.

The 21-valent pneumococcal conjugate vaccine (PCV21; CAPVAXIVE; Merck Sharp & Dohme) is the first pneumococcal conjugate vaccine (PCV) specifically designed for adults, targeting serotypes that currently cause disease in this population. PCV21 includes 11 serotypes not contained in any other approved PCV (9N, 15A, 15C, 16F, 17F, 20A, 23A, 23B, 24F, 31, and 35B), together with serotypes 3, 6A, 7F, 8, 10A, 11A, 12F, 19A, 22F, and 33F. PCV21 was approved by the Korean Ministry of Food and Drug Safety in August 27, 2025. The Adult Immunization Committee of the Korean Society of Infectious Diseases recommends one of the following options for all adults aged ≥65 years and for adults aged 19-64 years at increased risk of pneumococcal disease: a single dose of PCV21, a single dose of PCV20, or sequential PCV15 followed by PPSV23, with no stated preference among these options. When PCV21 or PCV20 is administered, no additional pneumococcal vaccination is required. Because PCV21 does not include serotype 4, in populations with a high incidence of serotype 4 disease, PCV20 alone or sequential PCV15 followed by PPSV23 may be preferentially considered.