- Pneumococcal
- Vaccine Products
Which pneumococcal vaccines are licensed for use in the United States?
One pneumococcal polysaccharide vaccine (PPSV23, Pneumovax 23, Merck) and three pneumococcal conjugate vaccines (PCV15 [Vaxneuvance, Merck], PCV20 [Prevnar 20, Pfizer], and PCV21 [Capvaxive, Merck]) are FDA-licensed and recommended by CDC for use in the United States. PCV13 (Prevnar 13, Pfizer) is FDA-licensed and may still be available in some clinics. It is no longer routinely recommended; however, CDC guidance allows for its use as previously recommended in situations where PCV15, PCV20, or PCV21 is indicated but unavailable and the alternative is that the patient would not be vaccinated.
PPSV23 is licensed for age 2 years and older. It was first licensed in 1983. It is an option for use in series with PCV15 for children and adults ages 2 through 64 years with specified risk factors for pneumococcal disease depending on their prior pneumococcal vaccination history. A PCV15 + PPSV23 series also is recommended as an option for pneumococcal disease prevention in adults 65 years and older. Following the 2022 changes to the pneumococcal vaccination schedule for adults, PPSV23 is no longer recommended alone, however PPSV23 is recommended for adults following PCV13 or PCV15 vaccination. It is not recommended for people who have previously received a PCV20 or PCV21 vaccination.
PCV15 is licensed for people age 6 weeks and older. CDC recommends the use of PCV15 as an option for the routine vaccination of children younger than age 5 years and certain children 6 through 18 years who have conditions that put them at high risk of invasive pneumococcal disease. CDC recommends PCV15 in series with PPSV23 as an option for pneumococcal disease prevention in adults age 19 through 64 years who are at increased risk for invasive pneumococcal disease due to behavioral or medical risk factors and for adults age 65 or older. When used in adults, it is always recommended to be used as part of a vaccination series with PPSV23 typically given 1 year later (a minimum interval of 8 weeks may be considered for people with immunocompromising medical conditions, cochlear implant or cerebrospinal fluid leak).
PCV20 is licensed for people age 6 weeks and older. CDC recommends the use of PCV20 as an option for the routine vaccination of children younger than 5 years of age and certain children 6 through 18 years who have conditions that put them at high risk of invasive pneumococcal disease. CDC recommends it as an option for pneumococcal disease prevention in adults age 19 through 64 years who are at increased risk for invasive pneumococcal disease due to behavioral or medical risk factors and for adults age 65 or older. If PCV20 is given, no further pneumococcal vaccination is recommended.
PCV21 was first licensed and recommended for adults in June 2024. CDC recommends the use of PCV21 as a product option for any adult age 19 or older when a PCV vaccine is recommended. It is specifically designed for adults: it does not contain 10 serotypes contained in PCV20; instead, it contains 11 additional serotypes that cause disease in adults. As with PCV20, after it is administered, no further pneumococcal vaccine doses are recommended.
For details of recommendations for these vaccines, see Recommendations for Pneumococcal Vaccines Use in Children and Teens, www.immunize.org/wp-content/uploads/catg.d/p2016.pdf, or Standing Orders for Administering Pneumococcal Vaccines to Adults: www.immunize.org/wp-content/uploads/catg.d/p3075.pdf.