Comparison of Pneumococcal Vaccines
(Modified February 2023)
The chart below compares the available U.S. pneumococcal vaccines including vaccine type, serotypes covered, dosing, immunity, and cost. See the CDC algorithm (https://www.cdc.gov/vaccines/vpd/pneumo/downloads/pneumo-vaccine-timing.pdf), for which adults should get which pneumococcal vaccine.
--Information in the chart below is from the product labeling (footnote a), unless otherwise indicated--
Vaccine |
Pneumovax 23 (PPSV23) |
Prevnar 13 (PCV13) |
Vaxneuvance (PCV15) |
Prevnar 20 (PCV20) |
Type of vaccinea |
polysaccharide |
conjugateb |
conjugateb |
conjugateb |
Additional serotypes coveredc |
2, 8, 9N, 10A, 11A, 12F, 15B,17F, 20, 22F, 33F |
6A |
6A, 22F, 33F |
6A, 8, 10A, 11A, 12F, 15B, 22F, 33F |
Approved age and dose |
≥50 years old ≥2 years old at increased risk for pneumococcal diseased
|
6 weeks to 5 years old:
≥6 years old
|
6 weeks to 5 years old:
≥18 years old
|
≥18 years oldf
|
Comments |
~8% to 15% of invasive disease (depending on age) is caused by serotypes only covered by this vaccine.3 |
Routine vaccination workhorse for kids. Recommended in adults with certain conditions. Only covers ~30% of serotypes causing invasive disease.3 |
Covers additional serotypes causing ~15% of invasive disease NOT covered by PCV13 in patients ≥19 years old.3 Does NOT provide additional coverage compared to PCV20. |
Covers additional serotypes causing ~30% of invasive disease NOT covered by PCV13 in patients ≥19 years old.3 |
Immunity |
Models project linear decline over 15 years.3 |
Models project no decline for 5 years, followed by linear decline over 10 years.3 |
||
Evidence suggests these may have a greater immune response than PPSV23 against most serotypes they have in common.3-5 |
||||
Cost per dosee |
~$120 |
~$215 |
~$220 |
~$240 |
- US product labeling: Pneumovax 23 (April 2021); Prevnar 13 (July 2019); Vaxneuvance (June 2022); Prevnar 20 (June 2021).
- The act of conjugating or linking the polysaccharide vaccine to a carrier protein enhances immunogenicity.1
- All available pneumococcal vaccines contain the following serotypes: 1, 3, 4, 5, 6B, 7F, 9V, 14, 18C, 19A, 19F, and 23F.a
- Examples of conditions that may increase the risk for pneumococcal disease include: anatomic or functional asplenia, sickle cell disease, human immunodeficiency virus infection, chronic heart or lung disease, cerebrospinal fluid leaks, and diabetes mellitus.2
- Pricing is based on wholesale acquisition cost (WAC). Medication pricing by Elsevier, accessed November 2021.
- Approval for use in children anticipated in 2023 (PCV20).3
References
- CDC. Principles of vaccination. In: Epidemiology and prevention of vaccine-preventable diseases. The Pink Book: Course Textbook. 14th Ed. 2021. https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/prinvac.pdf. (Accessed November 4, 2021).
- Nuroti JP, Whitney CG, Centers for Disease Control and Prevention (CDC). Prevention of pneumococcal disease among infants and children – use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine – recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2010;59:1-18.
- CDC. Considerations for age-based and risk-based use of PCV15 and PCV20 among U.S. adults and proposed policy options. October 20, 2021. https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-10-20-21/02-Pneumococcal-Kobayashi-508.pdf. (Accessed November 4, 2021).
- Hurley D, Griffin C, Young Jr M, et al. Safety, tolerability, and immunogenicity of a 20-valent pneumococcal conjugate vaccine (PCV20) in adults 60 to 64 years of age. Clin Infect Dis 2021;73:e1489-97.
- Song JY, Chang CJ, Andrews C, et al. Safety, tolerability, and immunogenicity of V114, a 15-valent pneumococcal conjugate vaccine, followed by sequential PPSV23 vaccination in healthy adults aged ≥50 years: a randomized phase III trial (PNEU-PATH). Vaccine 2021;39:6422-36.
Cite this document as follows: Clinical Resource, Comparison of Pneumococcal Vaccines. Pharmacist’s Letter/Prescriber’s Letter. December 2021. [371202]