Expect More Use of Prevnar 20 or Vaxneuvance

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).

When taking med histories, follow pharmacy policies for including prior immunizations. This info may influence the choice and timing of pneumococcal vaccine if it's given in-house.

For example, an eligible adult with no prior pneumococcal vaccine should receive Prevnar 20 alone...or Vaxneuvance PLUS Pneumovax 23, usually after 1 year.

Anticipate that the choice may boil down to what's on formulary...CDC guidelines don't suggest one approach over another.

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

But don't expect to dispense Prevnar 20 or Vaxneuvance for adults who got Prevnar 13. There aren't data on whether it adds much benefit.

See our tech tutorial, The Basics of Immunization and Vaccines, for dispensing, 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 (3-4-22)
  • 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
Hospital Pharmacy Technician's Letter. March 2022, No. 380312

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