Recommended Dosage and Administration Schedule for Pneum 20 (Pneumococcal Conjugate) Vaccine
For adults aged 18 years and older, Pneum 20 (PCV20) is administered as a single 0.5 mL dose by intramuscular injection. 1
Administration Guidelines
Preparation
- Hold the pre-filled syringe horizontally and shake vigorously until the vaccine becomes a homogeneous white suspension 1
- Visually inspect for particulate matter or discoloration before administration 1
- Do not mix with other vaccines in the same syringe 1
- Attach an appropriate needle for intramuscular injection 1
Administration Technique
- Administer as an intramuscular injection only 1
- Use the supplied pre-filled syringe with attached sterile needle 1
Dosing Schedules Based on Patient Population
Adults ≥65 Years of Age
- No previous pneumococcal vaccination: Administer a single dose of PCV20 2
- Previous PPSV23 only: Administer a single dose of PCV20 ≥1 year after the last PPSV23 dose 2
- Previous PCV13 only: Administer a single dose of PCV20 ≥1 year after the PCV13 dose 2
- Previous PCV13 and PPSV23 (with PPSV23 at age <65 years): Administer a single dose of PCV20 ≥5 years after the last pneumococcal vaccine dose 2
- Previous PCV13 and PPSV23 (with PPSV23 at age ≥65 years): Shared clinical decision-making regarding administration of PCV20 ≥5 years after the last pneumococcal vaccine dose 2
Adults 19-64 Years with Immunocompromising Conditions, CSF Leak, or Cochlear Implant
- No previous pneumococcal vaccination: Administer a single dose of PCV20 2
- Previous PPSV23 only: Administer a single dose of PCV20 ≥1 year after the last PPSV23 dose 2
- Previous PCV13 only: Administer a single dose of PCV20 ≥1 year after the PCV13 dose 2
- Previous PCV13 and 1 dose of PPSV23: Administer a single dose of PCV20 ≥5 years after the last pneumococcal vaccine dose 2
- Previous PCV13 and 2 doses of PPSV23: Administer a single dose of PCV20 ≥5 years after the last pneumococcal vaccine dose 2
Adults 19-64 Years with Chronic Medical Conditions
- No previous pneumococcal vaccination: Administer a single dose of PCV20 2
- Previous PPSV23 only: Administer a single dose of PCV20 ≥1 year after the last PPSV23 dose 2
- Previous PCV13 only: Administer a single dose of PCV20 ≥1 year after the PCV13 dose 2
- Previous PCV13 and PPSV23: Review vaccination recommendations when person reaches age 65 years 2
Special Population: Hematopoietic Stem Cell Transplant (HSCT) Recipients
- No previous vaccination after HSCT: Administer 3 doses of PCV20, 4 weeks apart starting 3-6 months after HSCT, followed by a fourth PCV20 dose ≥6 months after the third dose or ≥12 months after HSCT, whichever is later 2
- Received ≥1 dose of PCV13 or PCV15 after HSCT: Complete the 4-dose series with PCV20, with the first 3 doses 4 weeks apart starting 3-6 months after HSCT, and the fourth dose ≥6 months after the third dose or ≥12 months after HSCT, whichever is later 2
Recent Updates to Recommendations
- As of October 2024, ACIP has expanded recommendations to include a single dose of PCV for all PCV-naïve adults aged ≥50 years 3
- The 2024 recommendations now include the option of using 21-valent pneumococcal conjugate vaccine (PCV21) with similar dosing schedules as PCV20 2
Important Clinical Considerations
- PCV20 can be administered at the same visit as other age-appropriate vaccines at different anatomic sites 2
- Clinical trials have shown robust immune responses to PCV20 regardless of prior pneumococcal vaccination history 4
- The safety profile of PCV20 is comparable to that of PCV13 and PPSV23 in adults ≥65 years of age 4, 5
- For patients who have received PCV15 but have not completed their recommended pneumococcal vaccine series with PPSV23, one dose of PCV20 may be used if PPSV23 is not available 2
Common Pitfalls to Avoid
- Failing to check the patient's prior pneumococcal vaccination history, which determines the appropriate timing of PCV20 administration 2
- Not waiting the recommended interval between different pneumococcal vaccines (typically ≥1 year after PCV13 or ≥1 year after PPSV23) 2
- Overlooking the need for a special dosing schedule in HSCT recipients 2
- Not considering the expanded age recommendation for adults aged 50-64 years in the most recent guidelines 3