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This combination refers to the therapeutic use of both pneumococcal polysaccharide conjugate vaccine (PCV) and pneumococcal polysaccharide vaccine (PPSV) to prevent infections caused by *Streptococcus pneumoniae*. PCVs, such as PCV13, PCV15, and PCV20, consist of purified capsular polysaccharides from specific serotypes covalently linked to a carrier protein (typically CRM197). This conjugation converts the polysaccharide into a T-cell dependent antigen, inducing high-affinity antibodies, mucosal immunity, and long-term immunological memory, making it effective in infants and for reducing nasopharyngeal carriage. In contrast, PPSVs, most notably the 23-valent PPSV23, contain purified capsular polysaccharides without a carrier protein. These elicit a T-cell independent immune response that provides broader coverage against a larger number of serotypes but lacks the memory response and effectiveness in young children. The combination or sequential administration of these two vaccine types is a standard clinical strategy in adults aged 65 and older and immunocompromised individuals to maximize both the potency and the breadth of protection against invasive pneumococcal disease (IPD) and pneumonia.
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