*Hep A Vaccine may be given to those at risk for hepatitis A virus infection including those with chronic liver disease, HIV, men who have sex with men, use recreational drugs, persons experiencing homelessness, who travel to highly endemic area with hepatitis A or have close personal contact.
** Age 19 through 64 years with chronic medical conditions (chronic heart [excluding hypertension], lung, or liver disease, diabetes), alcoholism, or cigarette smoking: 1 dose PPSV23 l Age 19 years or older with immunocompromising conditions: 1 dose PCV13 followed by 1 dose PPSV23 at least 8 weeks later, then another dose PPSV23 at least 5 years after previous PPSV23
*** Age 65 years or older, administer 1 dose PPSV23 at least 5 years after most recent PPSV23 (note: only 1 dose PPSV23 recommended at age 65 years or older