Compare New Pneumococcal Vaccines to Prevnar 13 and Pneumovax 23

You'll see two new pneumococcal vaccines for adults, Prevnar 20 and 15-valent Vaxneuvance.

The new products are conjugate vaccines...like Prevnar 13.

The act of conjugating...or linking...to a carrier protein spurs production of memory cells. This may lead to longer-lasting and better immunity than polysaccharide vaccines, such as Pneumovax 23.

For example, Pneumovax 23 antibody levels are projected to start waning faster than Prevnar 20 or Vaxneuvance.

And evidence suggests conjugate vaccines lead to a greater antibody response than Pneumovax 23 against most serotypes they have in common.

But there aren't data yet on whether the new vaccines reduce rates of bacteremia, meningitis, or pneumonia.

Also be ready for questions about how serotype coverage compares.

Both new vaccines cover the same 13 serotypes as Prevnar 13. Prevnar 20 also covers 7 more serotypes, which cause about 30% of invasive disease...Vaxneuvance covers 2 more, which cause about 15%.

Pneumovax 23 still has broader serotype coverage. And at least 8% of invasive disease is caused by serotypes only covered by Pneumovax 23.

Plus Prevnar 20 or Vaxneuvance costs about $230...Pneumovax 23 is about $120.

Expect upcoming CDC adult pneumococcal guidelines to prefer the new conjugate vaccines.

That's because CDC models project that the better immunity with these new vaccines may modestly reduce overall pneumococcal disease and healthcare costs.

Stay tuned for our take on who should get these vaccines and when...once the CDC recommendations are finalized. Follow current guidelines in the meantime.

Continue to use Prevnar 13 for kids for now. But anticipate pediatric approval for Vaxneuvance in early 2022...and Prevnar 20 in 2023.

Get a side-by-side look at the various products in our chart, Comparison of Pneumococcal Vaccines.

Key References

  • https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-10-20-21/02-Pneumococcal-Kobayashi-508.pdf (11-18-21)
  • https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-09-29/02-Pneumococcal-Leidner-508.pdf (11-18-21)
  • https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-06/02-Pneumococcal-Gierke-508.pdf (11-18-21)
  • Clin Infect Dis. 2021 Oct 5;73(7):e1489-e1497
  • Vaccine. 2021 Oct 15;39(43):6422-6436
  • Medication pricing by Elsevier, accessed Nov 2021
Pharmacist's Letter. December 2021, No. 371202



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