What is the recommended pneumococcal vaccination regimen, including Prevnar 20 (pneumococcal conjugate vaccine), for individuals with pulmonary fibrosis?

From the Guidelines

For individuals with pulmonary fibrosis, the recommended pneumococcal vaccination regimen is a single dose of Prevnar 20 (PCV20), as stated in the most recent guidelines from 2024 1. This pneumococcal conjugate vaccine provides protection against 20 serotypes of Streptococcus pneumoniae bacteria that can cause serious infections. Patients with pulmonary fibrosis are considered high-risk for pneumococcal disease due to their compromised lung function, making vaccination particularly important. No additional pneumococcal vaccines are needed after receiving PCV20. The vaccine works by stimulating the immune system to produce antibodies against the bacterial capsular polysaccharides, providing protection against invasive pneumococcal disease, pneumonia, and other serious infections. Some key points to consider:

• The vaccine is administered as a single 0.5 mL intramuscular injection, typically in the deltoid muscle.
• Common side effects may include injection site pain, fatigue, muscle pain, and headache, which are usually mild and resolve within a few days.
• Patients should inform their healthcare provider about any previous pneumococcal vaccinations they've received, as the recommendation may be adjusted based on vaccination history. It's also worth noting that annual influenza vaccination and anti-pneumococcal vaccination are recommended for patients with idiopathic pulmonary fibrosis, as stated in guidelines from 2014 1. However, the most recent and highest quality study from 2024 1 takes precedence, and it recommends a single dose of PCV20 for individuals with pulmonary fibrosis. Other studies, such as those from 2023 1, provide additional guidance on pneumococcal vaccination regimens, but the 2024 study 1 is the most relevant and up-to-date.

From the Research

Pneumococcal Vaccination Regimen for Individuals with Pulmonary Fibrosis

• The recommended pneumococcal vaccination regimen for individuals with pulmonary fibrosis includes the use of pneumococcal conjugate vaccines, such as Prevnar 20 (PCV20) 2.
• Individuals with chronic pulmonary diseases, including pulmonary fibrosis, should be vaccinated with both 13-valent pneumococcal conjugate vaccine and the pneumococcal polysaccharide vaccine 23-valent, especially if they are taking steroids or immunomodulating therapy 3.
• The Advisory Committee on Immunization Practices (ACIP) recommends a single dose of PCV for all PCV-naïve adults aged ≥50 years, including those with pulmonary fibrosis 2.
• Studies have shown that pneumococcal vaccines can induce immune responses in patients with interstitial lung disease, including those with pulmonary fibrosis, although the response may be lower in patients undergoing immunosuppressive therapy 4.
• Coadministration of PCV13 and quadrivalent inactivated influenza vaccine has been shown to be safe and effective in adults previously immunized with polysaccharide pneumococcal vaccine 23, including those with pulmonary fibrosis 5.

Key Considerations

• Individuals with pulmonary fibrosis should consult with their healthcare provider to determine the best pneumococcal vaccination regimen for their specific needs.
• The use of PCV20 (Prevnar 20) may be recommended for individuals with pulmonary fibrosis, especially if they are aged ≥50 years and have not previously received a pneumococcal conjugate vaccine 2.
• Immunosuppressive therapy may affect the response to pneumococcal vaccines, and individuals with pulmonary fibrosis should discuss their treatment plan with their healthcare provider 4.