Pneumococcal Vaccination After Prevnar 13 and Pneumovax 23
If you've already received both Prevnar 13 and Pneumovax 23, you do not need Prevnar 20 as part of your routine vaccination schedule. According to the most recent 2024 Advisory Committee on Immunization Practices (ACIP) guidelines, a supplemental dose of PCV20 or PCV21 is only recommended through shared clinical decision-making for adults aged ≥65 years who have completed their recommended pneumococcal vaccine series with both PCV13 and PPSV23 1.
Current Recommendations Based on Your Vaccination History
If you have already received both PCV13 (Prevnar 13) and PPSV23 (Pneumovax 23), your pneumococcal vaccination series is considered complete according to current guidelines. The 2023-2024 ACIP recommendations specifically address this situation:
- For adults who have received both PCV13 and PPSV23: Your vaccination series is considered complete 1.
- For adults ≥65 years who received both vaccines: Shared clinical decision-making is recommended regarding whether to administer a supplemental dose of PCV20 or PCV21, but this is not routinely recommended 1.
Considerations for Special Populations
There are some exceptions where additional vaccination might be considered:
Immunocompromised individuals: If you have an immunocompromising condition, cerebrospinal fluid leak, or cochlear implant and are under 65 years of age, your vaccination status should be reviewed again when you reach age 65 1.
Cancer patients: According to the National Comprehensive Cancer Network (NCCN) guidelines, patients who have previously received PCV13 and 1 or 2 doses of PPSV23 can receive PCV20 at least 5 years after their last pneumococcal vaccine dose 1.
Potential Benefits and Limitations of Additional Vaccination
If you're considering an additional dose of PCV20 despite having completed the recommended series:
Potential benefit: PCV20 covers 7 additional serotypes not included in PCV13, which could provide broader protection against pneumococcal disease 1.
Limitation: Receipt of PPSV23 prior to PCV20 can result in diminished immune response to PCV20. According to the FDA label, "receipt of PPSV23 1 to 5 years prior to Prevnar 20 resulted in diminished OPA geometric mean titers (GMTs) to Prevnar 20 compared to OPA GMTs in recipients who received Prevnar 13 at least 6 months prior to Prevnar 20" 2.
Conclusion
Based on current ACIP guidelines, if you have already received both PCV13 and PPSV23, you do not need Prevnar 20 as part of your routine vaccination schedule. The only exception would be if you are ≥65 years of age, where shared clinical decision-making with your healthcare provider is recommended regarding a supplemental dose of PCV20 or PCV21, or if you have specific medical conditions that might warrant additional protection.
If you have concerns about your specific risk factors for pneumococcal disease, discuss with your healthcare provider whether the potential benefits of additional serotype coverage with PCV20 would outweigh the potentially diminished immune response due to your prior PPSV23 vaccination.