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New Pneumonia, Shingles, and Hepatitis Vaccine Recommendations [2022]


Centers for Disease Control 2022 Recommendations

In February 2022, the CDC came out with its new vaccine recommendations. In this post, I will summarize the important changes for people who are immunosuppressed (such as people with systemic lupus erythematosus). I will make this short and to the point. I will only include those for adults aged 19 and older.


Pneumonia shots against Pneumococcal Pneumonia

  • PCV13 (Prevnar 13) is no longer recommended
  • The Pneumovax every 5 year recommendation is also no longer recommended
  • Getting another Pneumovax after turning 65 if someone gets a Pneumovax before 65 years of age is no longer recommended (in other words, only one Pneumovax in one’s lifetime for those who receive a Pneumovax per the schedule below)
  • The pneumonia vaccine schedule is greatly simplified
  • Immunosuppressed patients (this includes all systemic lupus patients, including those who only take hydroxychloroquine) 19 and older should get one of the following:
    • PCV20 (Prevnar 20) and no other pneumonia shots after that, or get a…
    • PCV15 (Vaxneuvance) followed at least a year later by a PCV23 (Pneumovax) vaccine and no more after that
  • If someone accidentally gets Pneumovax initially, this should be followed by either a Prevnar 20 or a Vaxneuvance at least one year later
  • If someone has already received a Prevnar 13 shot (and no other pneumonia shots), they should get a Pneumovax at least one year later



Image of a man with herpes zoster rash across chest


All immunosuppressed patients should get the Shingrix vaccine series against shingles (herpes zoster)

Shingrix (Shingles) vaccine recommendations

The FDA had already approved the use of Shingrix for the prevention of shingles in people aged 19 and older who have compromised immune systems. However, insurance companies were rarely covering it yet for people aged 49 and younger. In February 2022, the CDC formally added this recommendation to the adult immunization schedule.

Systemic lupus patients are generally three times more likely to get shingles (due to the chickenpox or herpes zoster virus) than older healthy individuals. I, and many other rheumatologists who specialize in caring for lupus patients, recommend that all of our systemic lupus patients get the Shingrix vaccine followed by a further booster shot 2 to 6 months later.

yellow eye from jaundice due to hepatitis
Now it is recommended that everyone 19 to 59 years old get hepatitis B vaccines

Hepatitis B Vaccine Recommendations

Previously, the CDC only recommended hepatitis B vaccines for high-risk individuals. Now, it is recommended for everyone who is 19 to 59 years old. People who are 60 and older should get it if they have risk factors for hepatitis. 

Other vaccine recommendations for systemic lupus patients

  • There are currently no other big changes. I (and the CDC) still recommend the following (in a nutshell)
  • Flu shot (influenza) yearly, particularly in early September to mid October is preferable in the Northern hemisphere
  • Gardasil series against HPV virus associated cancers, before sexual activity is preferable.

Have you received your vaccines?
How did you do?
Did you have any reactions or did your lupus flare afterwards?

Please leave your comments below

For more in-depth information on New Pneumonia, Shingles, and Hepatitis Vaccine Recommendations [2022]:

Read more in The Lupus Encyclopedia, edition 2

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  1. Hello Dr. Thomas : I’ve read that Daniel Wallace mentioned a future where a “Lupus Vaccine” would be used to prevent Lupus, what can it do for those already living with the disease? Will the malaria vaccine be therapeutic and show any benefit in controlling SLE symptoms? Is there any progress towards finding a “cure”?

    • MH: My good friend, Dr. Wallace… what a great guy! I hope his dream is reached some day. Since he made that comment, though, new lupus-related genes are being discovered all the time (now around 150), so one anti-lupus vaccine is appearing more difficult. Like him, I hope we find a cure sooner than later.

      Donald Thomas, MD

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