What is the difference between Prevnar 20 (Pneumococcal Conjugate Vaccine) and Prevnar 13 (Pneumococcal Conjugate Vaccine)?

From the Guidelines

Prevnar 20 is the preferred choice over Prevnar 15 for adults due to its broader protection against pneumococcal disease, covering 20 strains of Streptococcus pneumoniae bacteria, as recommended by the Advisory Committee on Immunization Practices (ACIP) in 2023 1.

Key Considerations

• Prevnar 20 (PCV20) provides protection against 5 additional serotypes (8, 10A, 11A, 12F, and 15B) compared to Prevnar 15 (PCV15), which are responsible for approximately 27% of invasive pneumococcal disease cases in adults.
• The ACIP recommends PCV20 as a single dose for adults who have never received a pneumococcal vaccine, or for those who have previously received PPSV23, PCV13, or PCV15, with specific interval recommendations 1.
• Both vaccines have similar safety profiles, with common side effects including injection site pain, fatigue, muscle pain, headache, and joint pain.

Vaccine Administration

• Prevnar 20 and Prevnar 15 are administered as a single intramuscular injection for adults, typically in the deltoid muscle.
• The choice between these vaccines may depend on availability, cost considerations, and the healthcare provider's recommendation based on the individual's specific health situation and risk factors for pneumococcal disease.

Recommendations

• For adults who have never received a pneumococcal vaccine, either PCV20 alone or PCV15 followed by PPSV23 (Pneumovax 23) at least one year later is recommended 1.
• For adults who have previously received PPSV23, PCV13, or PCV15, the ACIP provides specific recommendations for the use of PCV20, including interval requirements 1.

From the FDA Drug Label

Prevnar 20, Pneumococcal 20-valent Conjugate Vaccine is a sterile suspension of saccharides of the capsular antigens of S. pneumoniae serotypes 1,3,4,5, 6A, 6B, 7F, 8, 9V, 10A, 11A, 12F, 14, 15B, 18C, 19A, 19F, 22F, 23F, and 33F, individually linked to non-toxic diphtheria CRM197 protein. Efficacy and effectiveness of Prevnar and Prevnar 13 are relevant to Prevnar 20, since Prevnar, Prevnar 13 and Prevnar 20 are manufactured similarly. In addition, Prevnar and Prevnar 20 contain 7 of the same polysaccharide conjugates and Prevnar 13 and Prevnar 20 contain 13 of the same polysaccharide conjugates

The main difference between Prevnar 20 and Prevnar 15 (also known as Prevnar 13) is the number of pneumococcal serotypes they protect against.

• Prevnar 20 protects against 20 serotypes, while
• Prevnar 15 (Prevnar 13) protects against 13 serotypes. Since the label does not directly compare the efficacy of Prevnar 20 and Prevnar 15, no conclusion can be drawn about their relative effectiveness 2.

From the Research

Comparison of Prevnar 20 and Prevnar 15

• Prevnar 20 is a 20-valent pneumococcal conjugate vaccine that provides protection against 20 serotypes of Streptococcus pneumoniae, while Prevnar 15 is not mentioned in the provided studies, but Prevnar 13 (PCV13) is, which is a 13-valent pneumococcal conjugate vaccine that provides protection against 13 serotypes of Streptococcus pneumoniae 3.
• The Advisory Committee on Immunization Practices (ACIP) recommends the use of a pneumococcal conjugate vaccine (PCV) for all adults aged ≥65 years, as well as for those aged 19-64 years with risk conditions for pneumococcal disease who have not received a PCV or whose vaccination history is unknown. Options include either 20-valent PCV (PCV20; Prevnar20) or 21-valent PCV (PCV21) alone or 15-valent PCV (PCV15) in series with 23-valent pneumococcal polysaccharide vaccine (PPSV23) 4.
• Studies have shown that PCV20 is well tolerated and immunogenic in adults, with a safety profile similar to that of PCV13 5, 6.
• PCV20 has been shown to induce robust immune responses to all 20 serotypes covered by the vaccine, including the 7 additional serotypes not covered by PCV13 3, 5, 6.

Immunogenicity and Safety

• The immunogenicity of PCV20 has been demonstrated in several clinical trials, which have shown that the vaccine induces robust immune responses to all 20 serotypes covered by the vaccine 3, 5, 6.
• The safety profile of PCV20 is similar to that of PCV13, with local reaction and systemic event rates being similar after vaccination with PCV20 or PCV13 5, 6.
• PCV20 has been shown to be well tolerated in adults, with no serious vaccine-related adverse events reported in clinical trials 5, 6.

Recommendations

• The ACIP recommends a single dose of PCV for all PCV-naïve adults aged ≥50 years 4.
• The use of PCV20 or PCV21 is recommended for adults who started their pneumococcal vaccination series with PCV13 4.