CDC's ACIP adult recommendations

THE CDC'S ACIP RECOMMENDS PREVNAR 13® (PNEUMOCOCCAL 13-VALENT CONJUGATE VACCINE [DIPHTHERIA CRM197 PROTEIN]) FOR IMMUNOCOMPROMISED ADULTS AGED ≥19 AND FOR IMMUNOCOMPETENT ADULTS AGED ≥65 BASED ON SHARED CLINICAL DECISION-MAKING1

Prevnar 13® (Pneumococcal 13-valent Conjugate Vaccine [Diphtheria CRM197 Protein]) is a vaccine approved for adults 18 years of age and older for the prevention of pneumococcal pneumonia and invasive disease caused by 13 Streptococcus pneumoniae strains (1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, and 23F). Prevnar 13® will only help protect against S. pneumoniae serotypes in the vaccine. Severe allergic reaction (eg, anaphylaxis) to any component of Prevnar 13® or any diphtheria toxoid–containing vaccine is a contraindication.

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

Immunocompetent adults aged 65 and older

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.​​​​​​
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ACIP=Advisory Committee on Immunization Practices; CDC=Centers for Disease Control and Prevention.​​​​​​​
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​​​For complete ACIP recommendations, visit the CDC Morbidity and Mortality Weekly Report website at www.cdc.gov/mmwr.​​​​​​

Announcement Title

Your adult patients' risk for pneumococcal disease has not changed

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.

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  • 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.

Patient profiles

Learn more about adult patients who may be appropriate candidates for vaccination with Prevnar 13® (Pneumococcal 13-valent Conjugate Vaccine [Diphtheria CRM197 Protein])

View patient profiles

Updated ACIP 65+ pneumococcal recommendations

​​​​​​​Hear from medical expert Donald B Middleton, MD.

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  • CDC's ACIP adult recommendations
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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.


Indication

  • In adults 18 years of age and older, Prevnar 13® is indicated for active immunization for the prevention of pneumonia and invasive disease caused by Streptococcus pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, and 23F

Limitations of Use and Effectiveness

  • Prevnar 13® will only help protect against S. pneumoniae serotypes in the vaccine
  • Severe allergic reaction (eg, anaphylaxis) to any component of Prevnar 13® or any diphtheria toxoid–containing vaccine is a contraindication
  • Immunocompromised individuals or individuals with impaired immune responsiveness due to the use of immunosuppressive therapy may have reduced antibody response
  • In adults, the most commonly reported solicited adverse reactions were pain, redness, and swelling at the injection site, limitation of arm movement, fatigue, headache, muscle pain, joint pain, decreased appetite, vomiting, fever, chills, and rash

Patients should always ask their doctors for medical advice about adverse events. You are encouraged to report negative side effects of vaccines to the US Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC). Visit www.vaers.hhs.gov or call 1-800-822-7967. This website is neither owned nor controlled by Pfizer. Pfizer does not endorse and is not responsible for the content or services of this site.

Please see full Prescribing Information for Prevnar 13®.

  • In adults 18 years of age and older, Prevnar 13® is indicated for active immunization for the prevention of pneumonia and invasive disease caused by Streptococcus pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, and 23F

Limitations of Use and Effectiveness

  • Prevnar 13® will only help protect against S. pneumoniae serotypes in the vaccine