Pneumococcal Disease Risk and Vaccination in Cardiac Conditions: Indian Cardiologists' Group Recommendations
India: A recent Indian expert consensus highlighted the importance of pneumococcal vaccination for individuals with chronic cardiac conditions who are at increased risk of developing pneumococcal disease (PD).
The study published in the July 2025 issue of the Indian Journal of Clinical Cardiology, emphasized the importance of pneumococcal vaccination for immunocompetent individuals with cardiac conditions, including those with prior myocardial infarction (MI) or coronary artery disease (CAD), heart failure (HF), chronic hypertension (CH), older adults over 50 with hypertension, and patients with acute coronary syndrome (ACS) and multiple comorbidities.
The author of the study Dr. JPS Sawhney, MD, DM (Cardiology), FESC, FACC, FRCP, Senior Consultant Cardiologist, Sir Ganga Ram Hospital, Delhi, India, shared his insights on the consensus and the recent introduction of the PCV20 vaccine, "The previous Delphi consensus recommending PCV13 followed by PPSV23 for adults with cardiac conditions was based on the need to broaden serotype coverage and enhance immune response in this high-risk group. With the availability of PCV20, which includes all serotypes in PCV13 plus 7 additional serotypes also covered by PPSV23, a single dose of PCV20 now offers comparable coverage long term protection without the need for sequential vaccination. Clinical trial data also confirms that PCV20 elicits non-inferior immune responses to other available pneumococcal vaccine. Importantly, these trials included adults with stable chronic cardiovascular disease, and the vaccine was well tolerated across age groups. Therefore, in light of this evidence and the simplified schedule, I would recommend a single dose of PCV20 for adults with cardiac conditions. This also aligns with current CDC/ACIP recommendations and improves compliance while maintaining robust serotype coverage."
PCV20, a newer pneumococcal conjugate vaccine recently introduced in India, provides protection against 20 serotypes of S. pneumoniae in a single dose, offering broader coverage and the advantage of simplified administration compared with the two-dose regimen. The latest CDC-ACIP and Indian Consensus Guidelines on Adult Immunisation suggest consideration of a single dose of PCV20 for all adults aged ≥50 years and for adults aged 19–49 years with immunocompromising conditions such as cancer, HIV, and AIRDs, as well as chronic diseases such as diabetes, chronic heart, lung, liver, or kidney disease.2,3
2. EMVAC. (2024). Adult vaccination booklet. EMVAC. https://www.emvac.in/wp-content/uploads/2024/06/Adult-Vaccination-Booklet.pdf
3. Kobayashi, M., Leidner, A. J., Gierke, R., Xing, W., Accorsi, E., Moro, P., Kamboj, M., Kuchel, G. A., Schechter, R., Loehr, J., & Cohen, A. L. (2025, January 9). Expanded recommendations for use of pneumococcal conjugate vaccines among adults aged ≥50 years: Recommendations of the Advisory Committee on Immunization Practices — United States, 2024. MMWR. Morbidity and Mortality Weekly Report, 74(1), 1–8. https://doi.org/10.15585/mmwr.mm7401a1
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