Which pneumococcal vaccines are licensed for use in the United States?

One pneumococcal polysaccharide vaccine (PPSV23, Pneumovax 23, Merck) and three pneumococcal conjugate vaccines [PCV13 (Prevnar 13, Pfizer), PCV15 (Vaxneuvance, Merck), and PCV20 (Prevnar 20, Pfizer)] are FDA-licensed and recommended by CDC for use in the United States.

PPSV23 is licensed for age 2 years and older. It was first licensed in 1983. It is recommended for children ages 2 years or older with specified risk factors for pneumococcal disease. It is recommended as an option, when used in series with PCV15, for adults 19 through 64 at increased risk for invasive pneumococcal disease due to behavioral or medical risk factors. 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 after PCV13 or PCV15 vaccination. It is not recommended for people who have previously received a PCV20 vaccination.

PCV13 is licensed for people age 6 weeks and older and was first licensed in 2010. Following the 2022 changes to adult pneumococcal vaccination recommendations, it is only recommended for use in children through age 18 years. CDC recommends the use of PCV13 for the routine vaccination of children younger than 5 years of age (4-dose series at age 2 months, 4 months, 6 months, and 12–15 months) and children 6 years and older without prior PCV13 vaccination who have certain medical conditions that put them at high risk of invasive pneumococcal disease. It is no longer recommended for use in adults.

PCV15 was licensed in 2021 for people age 18 years and older. CDC recommends it as an option for pneumococcal disease prevention in adults age 19 years or older who have not previously received a pneumococcal conjugate vaccine. 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 certain high-risk individuals). PCV15 followed by PPSV23 is an option for adults 19 through 64 at increased risk for invasive pneumococcal disease due to behavioral or medical risk factors or for adults age 65 or older.

PCV20 was licensed in 2021 for people age 18 years and older. CDC recommends it as an option for pneumococcal disease prevention in adults age 19 years or older who have not previously received a pneumococcal conjugate vaccine. If PCV20 is given, no further pneumococcal vaccination is recommended. PCV20 is an option for adults 19 through 64 at increased risk for invasive pneumococcal disease due to behavioral or medical risk factors or for adults age 65 or older.