Expect More Use of Prevnar 20 or Vaxneuvance Pneumococcal Vaccines

Which adults should get one of the new pneumococcal vaccines, Prevnar 20 or 15-valent Vaxneuvance, and when?

These products are conjugate vaccines like Prevnar 13...but cover more strains of the bacteria that cause pneumococcal disease.

And they may provide longer-lasting and better immunity than Pneumovax 23, which is a polysaccharide vaccine.

This is leading to changes in pneumococcal guidelines for adults 65 and up...or 19 to 64 with risk factors (cancer, diabetes, smoking, etc).

Update patient profiles with medical conditions, immunizations, etc. This can affect the choice and timing of pneumococcal vaccine given.

For example, eligible adults who've never had a pneumococcal vaccine should get Prevnar 20 alone...or Vaxneuvance PLUS Pneumovax 23, usually after 1 year. After that, no boosters are needed.

Expect your pharmacist to help patients weigh vaccine options.

For instance, Prevnar 20 may be more practical...since Vaxneuvance requires coming back for Pneumovax 23, to help cover more strains. If patients get Vaxneuvance, set up reminders...to finish the series.

Explain that all the vaccines will be covered by Medicare Part B.

Be aware, eligible adults who previously only had Pneumovax 23 may get either Prevnar 20 or Vaxneuvance alone...after a year.

For now, don't dispense Prevnar 20 or Vaxneuvance for adults who got Prevnar 13. There aren't data on whether this adds much benefit.

Check if patients getting a pneumococcal vaccine need other immunizations (COVID-19, etc)...these can be given at the same visit.

See our tech tutorial, The Basics of Immunization and Vaccines, for billing, storage, etc. And bookmark our chart, Comparison of Pneumococcal Vaccines, for a side-by-side look at products.

Key References

  • MMWR Morb Mortal Wkly Rep. 2022 Jan 28;71(4):109-117
  • https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-10-20-21/02-Pneumococcal-Kobayashi-508.pdf (2-25-22)
  • Clin Infect Dis. 2021 Oct 5;73(7):e1489-e1497
  • Vaccine. 2021 Oct 15;39(43):6422-6436
  • Medication pricing by Elsevier, accessed Feb 2022
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