A 65-year-old had PPSV23 when he was 60. Which immunization is due now?

The correct immunization due for this 65-year-old patient is the PPSV-13, which is a pneumococcal conjugate vaccine that is recommended to be given to adults aged 65 and older who have previously received PPSV23. The Advisory Committee on Immunization Practices (ACIP) recommends that individuals aged 65 and older receive a dose of PPSV-13 if they have not received it previously, along with the PPSV23.

This recommendation is based on the fact that different pneumococcal vaccines target different strains of the bacteria and provide additional protection against strains that may cause serious infections in older adults. Therefore, after receiving PPSV-23, it's important to discuss and offer administration of PPSV-13, especially since the patient is now beyond the recommended age and timeline for this immunization.

While other immunizations such as TDAP or influenza are important and do have specific recommendations for adults, they are not due specifically based on the information provided in the context of previous pneumococcal vaccination. Therefore, the focus here is rightly on the need to discuss and potentially administer PPSV-13 at this time.