Who should get one of the new pneumococcal vaccines, Prevnar 20 or 15-valent Vaxneuvance?
These products are conjugate vaccines like Prevnar 13...but cover more strains of the bacteria that cause pneumococcal disease.
And they may lead to longer-lasting and better immunity than Pneumovax 23, which is a polysaccharide vaccine.
This is leading to changes in pneumococcal guidelines.
Update patient profiles with medical conditions, immunizations, etc. This can affect the choice and timing of pneumococcal vaccine.
Adults will receive one dose of Prevnar 20 in most cases, depending on risk factors and vaccine history...or Vaxneuvance PLUS Pneumovax 23 as an alternative. After that, no boosters are needed.
Pneumovax 23 is given in addition to Vaxneuvance to broaden coverage. About 15% of invasive pneumococcal disease is caused by the 5 serotypes in Prevnar 20 that aren’t in Vaxneuvance.
Use the table below to help keep it all straight.
| Patient | Vaccine History | Recommended | Alternative |
| 18 to 64 years with an immunocompromising condition | No prior vaccine or vaccination status unknown | One dose of Prevnar 20 | Vaxneuvance followed by Pneumovax 23, separated by 8 weeks |
| 50 to 64 years with risk factors (diabetes, etc) | No prior vaccine or vaccination status unknown | One dose of Prevnar 20 | Vaxneuvance followed by Pneumovax 23, separated by 1 year |
| 65 years and older | No prior vaccine or vaccination status unknown | ||
| Pneumovax 23 at least 5 years prior | |||
| Prevnar 13 and Pneumovax 23 series at least 5 years prior | |||
| Prevnar 13 at least 1 year prior |
Expect Prevnar 20 to cost about $120/dose and Vaxneuvance plus Pneumovax 23 about $140...but these will likely be funded provincially.
For kids and adolescents, give either Prevnar 13 or Vaxneuvance...whichever you have in stock. It’s okay to interchange these...even partway through a primary series.
Use the opportunity to give other vaccines (COVID-19, etc) with a pneumococcal vaccine if needed.
Check out our resource, Comparison of Pneumococcal Vaccines, to compare serotypes covered, immunity, and more.
Expect Prevnar 20 to cost about $120/dose and Vaxneuvance plus Pneumovax 23 about $140...but these will likely be funded provincially.
Kids and adolescents will receive either Prevnar 13 or Vaxneuvance...dispense whichever you have in stock. It’s okay to interchange these...even partway through a primary series.
Check if patients getting a pneumococcal vaccine need other immunizations (COVID-19, etc)...these can be given at the same visit.
See our resource, The Basics of Immunization and Vaccines, for storage, etc. And bookmark our resource, Comparison of Pneumococcal Vaccines, for a side-by-side look at products.
- https://www.canada.ca/content/dam/phac-aspc/documents/services/immunization/national-advisory-committee-on-immunization-naci/public-health-level-recommendations-use-pneumococcal-vaccines-adults-including-use-15-valent-20-valent-conjugate-vaccines/recommendations-use-pneumococcal-vaccines-adults-15-20-valent-conjugate.pdf (5-3-23)
- https://www.canada.ca/content/dam/hc-sc/documents/services/publications/vaccines-immunization/national-advisory-committee-immunization-interim-guidance-pneumococcal-15-valent-conjugate-vaccine-pneu-c-15-pediatric-populations/national-advisory-committee-immunization-interim-guidance-pneumococcal-15-valent-conjugate-vaccine-pneu-c-15-pediatric-populations.pdf (5-3-23)
- https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2023-49/issue-2-3-february-march-2023/naci-statement-public-health-reccomendations-pneumococcal-vaccines.html (5-3-23)
- Chart: Comparison of Pneumococcal Vaccines
- Technician Tutorial: The Basics of Immunization and Vaccines