Medical conditions and risk factors include the following: Alcohol use disorder Chronic heart, lung, or liver disease Chronic renal failure or nephrotic syndrome Cigarette smoking Cochlear implant Congenital or acquired asplenia CSF leak Diabetes mellitus Generalized cancer HIV Hodgkin disease Immunodeficiency or immunosuppression Leukemia, lymphoma, or multiple myeloma Solid organ transplants Sickle cell disease or other hemoglobinopathies Children up to 18 years of age should receive the PCV13 pneumococcal vaccine (see table).