CDC's ACIP adult recommendations for Prevnar 13®

Immunocompetent adults aged 65 and older
The CDC's ACIP recommends Prevnar 13® for immunocompetent adults aged 65 and older based on shared clinical decision-making1
Pneumovax® 23 is recommended for all adults 65 and older. When the decision to administer Prevnar 13® is made, the information below represents the CDC’s ACIP recommendations to complete the pneumococcal vaccination sequence for immunocompetent adults aged 65 and older1
As stated by the CDC’s ACIP:
  • For adults aged ≥65 years with immunocompromising conditions, functional or anatomic asplenia, cerebrospinal fluid leaks, or cochlear implants, the recommended interval between Prevnar 13® (Pneumococcal 13-valent Conjugate Vaccine [Diphtheria CRM197 Protein]) followed by Pneumovax® 23 is ≥8 weeks1
  • The 2 vaccines (Prevnar 13® and Pneumovax® 23) should not be coadministered. If a dose of Pneumovax® 23 is inadvertently given earlier than the recommended interval, the dose need not be repeated3
  • For complete ACIP recommendations, visit the CDC Morbidity and Mortality Weekly Report
Prior receipt of Pneumovax® 23 within 1 year results in diminished immune responses to Prevnar 13® compared to Pneumovax® 23-naive individuals.4
Pneumovax is a registered trademark of Merck & Co., Inc.
ACIP=Advisory Committee on Immunization Practices; CDC=Centers for Disease Control and Prevention; IPD=invasive pneumococcal disease.
For complete ACIP recommendations, visit the CDC Morbidity and Mortality Weekly Report website at www.cdc.gov/mmwr.
The decision to vaccinate should be made at the individual level between you and your patients2
Immunocompromised adults aged 19 and older
The CDC’s ACIP recommends Prevnar 13® in series with Pneumovax® 23 for immunocompromised patients aged 19 and older with the following medical conditions2:
  • Congenital or acquired immunodeficiencies*
  • Human immunodeficiency virus (HIV)
  • Chronic renal failure
  • Nephrotic syndrome
  • Leukemia
  • Lymphoma
  • Hodgkin disease
  • Generalized malignancy
  • Iatrogenic immunosuppression†
  • Solid organ transplant
  • Multiple myeloma
  • Functional or anatomic asplenia (including sickle cell disease/other hemoglobinopathies and congenital or acquired asplenia)
  • Cerebrospinal fluid leaks‡
  • Cochlear implants‡
*Includes B- (humoral) or T-lymphocyte deficiency, complement deficiencies (particularly C1, C2, C3, and C4 deficiencies), and phagocytic disorders (excluding chronic granulomatous disease).
†Diseases requiring treatment with immunosuppressive drugs, including long-term systemic corticosteroids and radiation therapy.
‡With the exception of cerebrospinal fluid leak and cochlear implant, all medical conditions listed are immunocompromising conditions or conditions requiring treatment with immunosuppressive drugs.
  • A second dose of Pneumovax® 23 is recommended (≥8 weeks after a dose of Prevnar 13® (Pneumococcal 13-valent Conjugate Vaccine [Diphtheria CRM197 Protein]) and 5 years after the most recent dose of Pneumovax® 23) for persons aged 19-64 years with functional or anatomic asplenia (including sickle cell disease/other hemoglobinopathies and congenital or acquired asplenia) and for persons with immunocompromising conditions2
  • Additionally, those who received Pneumovax® 23 before age 65 for any indication should receive another dose of Pneumovax® 23 at age 65 or later if at least 5 years have elapsed since their previous Pneumovax® 23 dose2
For complete ACIP recommendations, visit the CDC Morbidity and Mortality Weekly Report website at www.cdc.gov/mmwr.
Medications that may lead to immunosuppression
  • According to the CDC, medications that may lead to immunosuppression include high-dose oral corticosteroids, alkylating agents, antimetabolites, transplant-related immunosuppressive drugs, cancer chemotherapeutic agents, tumor necrosis factor (TNF) blockers, and biologic agents.5
IMPORTANT PRESCRIBING INFORMATION FOR PREVNAR 13®
  • Individuals with altered immunocompetence, including those at higher risk for invasive pneumococcal disease (eg, individuals with congenital or acquired splenic dysfunction, HIV infection, malignancy, hematopoietic stem cell transplant, nephrotic syndrome), may have reduced antibody responses to immunization with Prevnar 13®4
  • Immunogenicity data for Prevnar 13® in adults who are at high risk for pneumococcal disease are limited to individuals with HIV infection or with a hematopoietic stem cell transplant. The effectiveness in these and other high-risk populations is not established4
  • The appropriate use of Prevnar 13® in adults with immunocompromising conditions should be based on a risk/benefit assessment by the practitioner for the individual patient
  • Prior receipt of Pneumovax® 23 within 1 year results in diminished immune responses to Prevnar 13® compared to Pneumovax® 23-naive individuals4
Pneumovax is a registered trademark of Merck & Co., Inc.
ACIP=Advisory Committee on Immunization Practices; CDC=Centers for Disease Control and Prevention.
Updated ACIP 65+ pneumococcal recommendations
Hear from medical expert Donald B Middleton, MD.
References:
  1. Matanock A, Lee G, Gierke R, Kobayashi M, Leidner A, Pilishvili T. Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among adults aged ≥65 years: updated recommendations of the Advisory Committee on Immunization Practices. MMWR Morb Mortal Wkly Rep. 2019;68:1069-1075. doi: http://dx.doi.org/10.15585/mmwr.mm6846a5.
  2. Centers for Disease Control and Prevention. Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine for adults with immunocompromising conditions: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2012;61(40):816-819.
  3. Kobayashi M, Bennett NM, Gierke R, et al. Intervals between PCV13 and PPSV23 vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2015;64(34):944-947.
  4. Prevnar 13® (Pneumococcal 13-valent Conjugate Vaccine [Diphtheria CRM197 Protein]) Prescribing Information, Wyeth Pharmaceuticals LLC, 2019.
  5. Centers for Disease Control and Prevention. Advising travelers with specific needs. In: Brunette GW, Kozarsky PE, eds. CDC Health Information for International Travel 2018. New York, NY: Oxford University Press; 2017.
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