II. Background
- Pneumovax 23 (PPSV23) is a purified capsular PolysaccharideAntigens from 23 serotypes
- These serotypes are responsible for 88% of invasive pneumococcal disease
- As of 2024 in U.S, PCV20 and PCV21 have replaced the use of Pneumovax 23 (PPSV23)
- Dual coverage with PPSV23 is no longer needed with PCV20 and PCV21
- Dual Immunization with PPSV23 is still needed if PCV13 or PCV15 are given
III. Dosing
- Dosing regimens are being modified in 2022 by CDC
- Prevnar 20 is sufficient alone, and does not require Pneumovax
- GIve Prevnar 20 alone (or Vaxneuvance AND Pneumovax 23)
- See Prevnar for dosing Pneumococcal Vaccine schedules
- Pneumovax 23 Indications (when Vaxneuvance or Prevnar 13 are used)
- One dose of Pneumovax 23 is sufficient for most patients at age 65 years
- Indication for single dose ages 2 to 64 years
- See Indications above
- Give a second dose at age 65 or at least 5 years after the last dose
- Indication for 2 doses at more than 5 years apart at ages 2 to 64 years
- Give third dose at age 65 years or at least 5 years after the last dose
- Chronic renal disease (Renal Failure, Nephrotic Syndrome)
- Asplenia
- Sickle Cell Anemia
- Immunocompromised state
- HIV Infection
- Leukemia
- Lymphoma
- Multiple Myeloma
- Iatrogenic (e.g. organ transplant, Radiation Therapy, Chemotherapy)
IV. Precautions
- Administer to high risk women before pregnancy
- ACIP recommends avoiding in pregnancy
-
Pneumococcal Vaccine may be given on same day as other Vaccines (e.g. Influenza Vaccine, Shingles Vaccine)
- Pneumococcal Conjugate Vaccine (e.g. PCV21) may have reduced Antibody response when given with Influenza Vaccine
- However, given both Vaccines (Prevnar and Influenza) does not reduce their efficacy
V. References
- (2024) Presc Lett 31(12): 67-8
- Presc Lett 22(11): 63
- Kobayashi (2022) MMWR Morb Mortal Wkly Rep 71(4): 109-17 [PubMed]
