"Highest Risk" categories for pneumococcal infection

Persons at highest risk include all people >2 years of age with functional or anatomic asplenia (e.g., sickle cell disease or splenectomy), HIV infection, leukemia, lymphoma, Hodgkins disease, multiple myeloma, generalized malignancy, chronic renal failure, nephrotic syndrome, or other conditions associated with immunosuppression (e.g., organ or bone marrow transplantation) and those receiving immunosuppressive chemotherapy, including long term corticosteroids. Persons aged 65 years and older should be administered a second dose of pneumococcal vaccine if they received the vaccine more than 5 years previously, and were less than 65 years of age at the time of the first dose.

Source: CDC's Epidemiology & Prevention of Vaccine-Preventable Diseases (Pink Book) chapter 17 pages, 241-242. Click here to view the entire chapter in PDF format.