6a. Pneumococcal conjugate vaccine (PCV). (Minimum age: 6 weeks) Routine vaccination:  Administer a series of PCV13 vaccine at ages 2, 4, 6 months with a  booster at age 12 through 15 months.  For children aged 14 through 59 months who have received an  age-appropriate series of 7-valent PCV (PCV7), administer a single  supplemental dose of 13-valent PCV (PCV13). Catch-up vaccination:  Administer 1 dose of PCV13 to all healthy children aged 24 through 59 months who are not completely vaccinated for their age.  For other catch-up issues, see Figure 2. Vaccination of persons with high-risk conditions:  For children aged 24 through 71 months with certain underlying medical  conditions (see footnote 6c), administer 1 dose of PCV13 if 3 doses of  PCV were received previously, or administer 2 doses of PCV13 at least 8  weeks apart if fewer than 3 doses of PCV were received previously.  A single dose of PCV13 may be administered to previously unvaccinated  children aged 6 through 18 years who have anatomic or functional  asplenia (including sickle cell disease), HIV infection or an immunocompromising condition, cochlear implant or cerebrospinal fluid  leak. See MMWR 2010;59 (No. RR-11), available at http://www.cdc.gov/mmwr/pdf/rr/rr5911.pdf.  Administer PPSV23 at least 8 weeks after the last dose of PCV to  children aged 2 years or older with certain underlying medical conditions  (see footnotes 6b and 6c).
6b. Pneumococcal polysaccharide vaccine (PPSV23). (Minimum age: 2  years) Vaccination of persons with high-risk conditions:  Administer PPSV23 at least 8 weeks after the last dose of PCV to  children aged 2 years or older with certain underlying medical conditions  (see footnote 6c). A single revaccination with PPSV should be  administered after 5 years to children with anatomic or functional asplenia  (including sickle cell disease) or an immunocompromising condition.
6c. Medical conditions for which PPSV23 is indicated in children aged 2  years and older and for which use of PCV13 is indicated in children aged 24 through 71 months:  Immunocompetent children with chronic heart disease (particularly  cyanotic congenital heart disease and cardiac failure); chronic lung disease (including asthma if treated with high-dose oral corticosteroid therapy), diabetes mellitus; cerebrospinal fluid leaks; or cochlear implant.  Children with anatomic or functional asplenia (including sickle cell disease and other hemoglobinopathies, congenital or acquired asplenia, or splenic dysfunction);  Children with immunocompromising conditions: HIV infection, chronic renal failure and nephrotic syndrome, diseases associated with treatment with immunosuppressive drugs or radiation therapy, including malignant neoplasms, leukemias, lymphomas and Hodgkin disease; or solid organ transplantation, congenital immunodeficiency.