What is the significance of transitioning from Pneumococcal Conjugate Vaccine (PCV) 13 in 2016 to Pneumococcal Conjugate Vaccine (PCV) 20 in 2025?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: April 8, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

If you received the PCV13 vaccine in 2016, getting PCV20 in 2025 is generally recommended for most adults, as it provides broader protection against pneumococcal disease by covering seven additional strains beyond what PCV13 covers. The CDC recommends waiting at least one year before receiving PCV20 after PCV13, which your timeline easily satisfies 1. This recommendation applies to adults 65 and older and those 19-64 with certain underlying medical conditions that increase risk for pneumococcal disease. Some key points to consider include:

  • The additional protection is valuable because pneumococcal bacteria can cause serious infections including pneumonia, meningitis, and bloodstream infections.
  • The vaccine works by helping your immune system develop antibodies against the capsular polysaccharides of the pneumococcal bacteria.
  • Side effects are typically mild and may include injection site pain, fatigue, muscle pain, headache, and joint pain lasting 1-3 days.
  • Consult with your healthcare provider to confirm this recommendation based on your specific health history and risk factors 1. It's also important to note that the immunogenicity of PCV20 among adults aged ≥65 years who had previous pneumococcal vaccination (PCV13 only, PPSV23 only, or both PCV13 and PPSV23) has been assessed in phase III studies, demonstrating that PCV20 is immunogenic in those aged ≥65 years who previously received a pneumococcal vaccine 1.

From the FDA Drug Label

Prevnar 20 effectiveness in adults against invasive pneumococcal disease caused by the 20 vaccine serotypes and against pneumonia caused by the 13 serotypes in Prevnar 13 was demonstrated based on comparative immunogenicity to US-licensed pneumococcal vaccines (Prevnar 13 and PPSV23). In individuals 60 years of age and older, immune responses to all 13 matched serotypes elicited by Prevnar 20 were noninferior to the immune responses to the serotypes elicited by Prevnar 13 one month after vaccination

The individual received PCV 13 in 2016. In 2025, they can receive PCV 20, as the immune responses to all 13 matched serotypes elicited by Prevnar 20 were noninferior to the immune responses to the serotypes elicited by Prevnar 13 one month after vaccination 2.

From the Research

PCV13 and PCV20 Development

  • PCV13 was introduced in 2016 to protect against 13 serotypes of pneumococcal disease 3.
  • A 20-valent pneumococcal conjugate vaccine (PCV20) is currently in development to expand protection against pneumococcal disease beyond PCV13, containing capsular polysaccharide conjugates of serotypes present in PCV13 and 7 new serotypes (8, 10A, 11A, 12F, 15B, 22F, and 33F) 4.
  • PCV20 has demonstrated robust and consistent immunogenicity in adults 60 to 64 years of age and in pneumococcal vaccine-naive adults 18 through 49 years of age 4, 5.

PCV20 Efficacy and Safety

  • Studies have shown that PCV20 is well tolerated in adults, with a safety profile consistent with historical experience of PCVs in this age group 4, 5.
  • PCV20 has elicited functional immune responses as measured by opsonophagocytic activity (OPA) titers for all 20 serotypes included in the vaccine 4, 5.
  • A phase 3 study in healthy infants demonstrated that a 4-dose series of PCV20 was well tolerated and elicited robust serotype-specific immune responses expected to help protect infants and young children against pneumococcal disease due to the 20 vaccine serotypes 6.

Comparison to PCV13

  • PCV13 was effective in preventing vaccine-type pneumococcal, bacteremic, and nonbacteremic community-acquired pneumonia and vaccine-type invasive pneumococcal disease in older adults 7.
  • PCV20 has the potential to expand pneumococcal disease protection beyond PCV13, with studies demonstrating its safety and immunogenicity in various populations 4, 5, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.