From the Guidelines
Based on the vaccination history provided, shared clinical decision-making is recommended regarding administration of PCV20 for any adult aged ≥65 years who has completed the recommended vaccine series with both PCV13 and PPSV23. The patient has already received both PPSV23 (pneumococcal polysaccharide vaccine) and PCV13 (pneumococcal conjugate vaccine) on April 27,2021, which constitutes complete pneumococcal vaccination coverage. Considerations for shared clinical decision-making might include the patient’s risk for pneumococcal disease due to underlying medical conditions, time since last pneumococcal vaccination, or risk for exposure to pneumococcal serotypes contained in PCV20 1. If a decision to administer PCV20 is made, a single dose of PCV20 is recommended ≥5 years after the last pneumococcal vaccine dose 1. The current pneumococcal vaccination protection for this patient should be considered adequate until future guidelines recommend otherwise. Key factors to consider in the shared decision-making process include the patient's individual risk factors, the potential benefits and risks of PCV20 vaccination, and the patient's preferences and values 1.
Some key points to consider in the decision-making process include:
- The patient's age and underlying medical conditions
- The time since the last pneumococcal vaccination
- The risk for exposure to pneumococcal serotypes contained in PCV20
- The potential benefits and risks of PCV20 vaccination
- The patient's preferences and values regarding vaccination 1.
It is essential to weigh these factors carefully and consider the latest guidelines and recommendations from the Advisory Committee on Immunization Practices (ACIP) when making a decision about PCV20 vaccination 1.
From the FDA Drug Label
Prior Pneumococcal Vaccination Status‡ PPSV23 Prevnar 13 Prevnar 13 and PPSV23 Vaccine Group Prevnar 20 (N§=253) % Prevnar 13 (N§=121) % Prevnar 20 (N§=245) % PPSV23 (N§=126) % Prevnar 20 (N§=125) %
The patient received PPSV 23 and PCV 13 on the same day (4/27/21). The PCV 20 recommendations are not directly addressed in the provided drug label for this specific scenario. However, the label does provide information on the administration of Prevnar 20 in individuals with prior pneumococcal vaccination, including those who received PPSV23 and Prevnar 13.
- The label does not provide a specific recommendation for the administration of PCV 20 in individuals who have already received PCV 13 and PPSV 23 on the same day.
- Given the lack of direct information, it is not possible to draw a conclusion about the PCV 20 recommendations for this patient. 2
From the Research
Pneumococcal Vaccination Recommendations
- The user received PPSV 23 and PCV 13 on 4/27/21, and is seeking recommendations for PCV 20.
- However, there is no information available on PCV 20 in the provided studies.
Available Pneumococcal Vaccines
- The currently licensed pneumococcal vaccines in the United States are PCV13 and PPSV23 3.
- PCV13 contains 13 serotypes, while PPSV23 contains 23 serotypes 4.
Vaccination Intervals and Effectiveness
- The Advisory Committee on Immunization Practices (ACIP) recommends a dose of PCV13 followed by a dose of PPSV23 in adults aged ≥65 years who have not previously received pneumococcal vaccine 3.
- A study found that a 1-year interval between PCV13 and PPSV23 provided better booster effects than a 0.5-year interval in pneumococcal vaccine-naïve adults aged ≥65 years 5.
- Another study found that PPSV23 was effective against invasive pneumococcal disease and pneumococcal pneumonia in adults aged ≥60 years, with a pooled vaccine efficacy of 73% against invasive pneumococcal disease and 64% against pneumococcal pneumonia 6.
Comparative Effectiveness of Pneumococcal Vaccines
- A retrospective cohort study found that PCV 13 was associated with a decreased risk of pneumococcal pneumonia and "other" pneumonia compared to PPSV 23 in older adults 7.
- Dual vaccination with PCV 13 and PPSV 23 was also associated with a decrease in the rate of pneumococcal pneumonia and "other" pneumonia compared to PPSV 23 alone 7.