From the Guidelines
The pneumococcal 21 vaccine (PCV21) is recommended for adults aged 65 and older, as well as those aged 19-64 with certain risk conditions, as it provides protection against 21 serotypes of Streptococcus pneumoniae bacteria, including additional disease-causing strains not covered by previous versions like PCV13 and PCV20 1.
Key Points
- The PCV21 vaccine is approved for the prevention of invasive pneumococcal disease caused by serotype 15B, and contains serotype 20A 1.
- The vaccine is typically administered as a single intramuscular injection in the deltoid muscle, with only one dose needed for complete protection.
- Side effects are generally mild and may include pain at the injection site, fatigue, headache, muscle pain, and low-grade fever, typically resolving within a few days.
Recommendations
- Adults aged 65 and older should receive the PCV21 vaccine to protect against invasive pneumococcal disease 1.
- Individuals 19-64 with certain risk factors, such as chronic heart, lung, or liver disease, diabetes, immunocompromising conditions, or cochlear implants, should also receive the PCV21 vaccine 1.
Vaccine Comparison
- PCV21 provides broader protection against pneumococcal disease compared to PCV20 and PCV15, with the addition of new serotypes 1.
- The vaccine serotypes included in PCV21, PCV20, PCV15, and PPSV23 are compared in the figure provided, highlighting the unique coverage of PCV21 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Pneumococcal 21 Vaccine Overview
- There is no direct mention of a Pneumococcal 21 vaccine in the provided studies, however, the studies discuss the 23-valent polysaccharide pneumococcal vaccine (PPV23) and the 13-valent pneumococcal conjugate vaccine (PCV13) 2, 3, 4, 5.
- A 15-valent pneumococcal conjugate vaccine (PCV15) is mentioned in one study, which evaluates its safety and immunogenicity in adults ≥65 years of age previously vaccinated with PPV23 6.
Vaccine Effectiveness
- The effectiveness of PPV23 in preventing invasive pneumococcal disease (IPD) was found to be 50% (95% CI: 21%-69%) for cohort studies and 54% (95% CI: 32%-69%) for case-control studies 3.
- The vaccine effectiveness of PPV23 in preventing IPD and all-cause community-acquired pneumonia (CAP) was consistent with past systematic reviews and similar to the estimates reported in the CAPiTA trial evaluating the vaccine effectiveness of PCV13 3.
- A meta-analysis found that the pooled vaccine efficacy/effectiveness (VE) of PPV23 against IPD was 73% (95%CI: 10-92%) in clinical trials, 45% (95%CI: 15-65%) in cohort studies, and 59% (95%CI: 35-74%) in case-control studies 4.
Vaccine Recommendations
- The currently available scientific evidence supports the following basic recommendations:
- Among adults with greatest risk (basically asplenia and immunocompromised), a dual vaccination (PCV13+PPV23) is recommended 2.
- Among adults with increased risk (basically persons >65years-old and patients 15-64years with chronic pulmonary or heart disease, diabetes and/or alcoholism), a single vaccination with PPV23 is recommended 2.
- In the rest of adults (risk normal/low) vaccination is not recommended 2.
Safety and Immunogenicity
- The safety profiles of PCV15 and PCV13 were found to be comparable in adults ≥65 years of age previously vaccinated with PPV23 6.
- PCV15 was generally well tolerated and induced high levels of IgG and OPA antibodies to all 15 serotypes included in the vaccine when given as a single dose to adults ≥65 years of age previously vaccinated with PPV23 6.