From the Guidelines
The recommended pneumococcal vaccine for adults is now the 21-valent pneumococcal conjugate vaccine (PCV21), as it provides the most comprehensive protection against Streptococcus pneumoniae, according to the latest guidelines from the Advisory Committee on Immunization Practices (ACIP) in 2024 1.
Key Considerations
- The ACIP recommends PCV21 for all adults aged ≥65 years, as well as those aged 19–64 years with a risk condition who have not received PCV or whose vaccination history is unknown.
- PCV21 offers protection against 21 serotypes of Streptococcus pneumoniae, including eight new serotypes not covered by other licensed vaccines.
- The vaccine has been shown to be safe and immunogenic, with considerations of resource use also taken into account 1.
Comparison with Other Vaccines
- Previous recommendations included the use of 20-valent PCV (PCV20) alone or 15-valent PCV (PCV15) followed by 23-valent pneumococcal polysaccharide vaccine (PPSV23) 1.
- However, the latest guidelines from 2024 supersede these recommendations, making PCV21 the preferred choice for adults 1.
Clinical Guidance
- Adults who have commenced their pneumococcal vaccination series with 13-valent PCV (PCV13) may also be recommended to receive PCV21, depending on their individual circumstances.
- Shared clinical decision-making is recommended for adults who have completed their recommended vaccine series with both PCV13 and PPSV23, regarding the use of a supplemental PCV21 dose.
From the Research
Pneumococcal Vaccine Recommendations
The recommended pneumococcal vaccine is the 13-valent pneumococcal conjugate vaccine (PCV13) [(2,3,4,5)].
- PCV13 is recommended for all adults aged ≥65 years, in series with the 23-valent pneumococcal polysaccharide vaccine (PPSV23) [(2,4)].
- PCV13 is also recommended for younger adults with immunocompromising conditions [(2,3)].
- The vaccine has been shown to be effective in preventing vaccine-type pneumococcal community-acquired pneumonia (CAP), vaccine-type pneumococcal nonbacteraemic (noninvasive) CAP, and vaccine-type invasive pneumococcal disease (IPD) 2.
Vaccine Administration
- PCV13 should be administered in series with PPSV23 for all adults aged ≥65 years [(2,4)].
- The US Advisory Committee on Immunization Practices (ACIP) recommends PCV13 for all adults aged ≥65 years, and for immunocompromised adults aged <65 years [(2,3)].
- PCV13 has been shown to be well tolerated in older adults, with a well-established immunogenicity and tolerability profile [(2,5)].