Another New Pneumonia Vaccine? Nope. Two.

Betty Chaffee/ April 8, 2022/ immunization, Medication Management, vaccines/ 0 comments

Pneumonia vaccines have been in use for years. And they're very effective at preventing serious illness in people of all ages. But just when we think we're on top of the best way to vaccinate, experts find new information and change the game. Recommendations for the best use of vaccines of all types change now and then. Guidelines for pneumonia vaccines have already changed in recent years. In 2014, pneumonia vaccination for adults over 65 became a two-shot series, using Prevnar 13 followed by Pneumovax 23. Then in 2019 we went back to a single shot of Pneumovax 23 for most adults, though  the two-shot series was still an option.

Now, another change. The FDA approved two new pneumonia vaccines for adults at the end of last year. Let me tell you about them and how the new guidelines may affect you.

New Pneumonia Vaccines

The two new vaccines are PCV 15 (Vaxneuvance) and PCV 20 (Prevnar 20). They are both "conjugate" vaccines, while Pneumovax 23 is a "polysaccharide" vaccine. Both types of vaccines are effective at preventing infections, but the immune response to the conjugate vaccine is somewhat more robust. 

It's also important to know what the numbers mean. The bacteria that causes pneumonia exists in a lot of different forms (called "serotypes"). You can think of it kind of like the "variants" of the Covid-19 virus. The number after the name shows how many different forms of the bacteria are covered by that particular vaccine.

The bacteria we're talking about here is Streptococcus pneumoniae, or pneumococcus. Pneumococcus is one of the most common causes of severe and life-threatening pneumonia in adults and young children. It can also cause serious infections outside of the lungs, most commonly meningitis and bloodstream infections. Pneumonia vaccination is very important to both public and individual health.

Public health experts continually look for better ways to prevent disease from the many forms of pneumococcus. The more robust and long-lasting the immune response to a vaccine, the better. So there's been a fair amount of research on the new vaccines. And it turns out that more pneumococcal infections can be prevented if the newest vaccines are added to the mix.

New Pneumonia Vaccination Guidelines

If you're 65 or older and you've never been vaccinated for pneumonia:: From 2019 until last month you would likely have needed just one dose of Pneumovax 23. Instead, now you'll need just one dose of Prevnar 20, OR one dose of PCV 15 followed a year later by a dose of Pneumovax 23. You won't need any boosters or extra shots after that.

What if you already had a pneumonia vaccine at the age of 65 or older? Here's where it starts getting complicated.

If you were given Prevnar 13 followed by Pneumovax 23 a year or so later, you're good. There's no need for any other pneumonia vaccine. BUT -- if you only got the Prevnar 13 part, you'll need to complete the series with a dose of Pneumovax 23. If you only had Pneumovax 23, you can choose to get either Prevnar 20 or PCV 15. Either one of those will provide the protection you need in combination with the original Pneumovax 23.

High risk adults: If you're 19 or older and immunocompromised, or have one of several underlying health problems, you should be vaccinated before age 65.  You should get either one dose of Prevnar 20, or one dose of PCV 15 followed a year later by one dose of Pneumovax 23. You won't need any further pneumonia vaccination in the future under these guidelines.

But if you already had a pneumonia vaccine, you'll need to complete the series. For the most part, the same rules detailed above will apply to you. If you had both PCV 13 and Pneumovax 23, you're likely done. (There are a few exceptions to this rule.) But if you only had one or the other, you'll need to complete the series as described above.

The good news is that, according to these new guidelines, you don't have to be re-vaccinated after you turn 65. Research shows that the protection from the first series of pneumonia vaccine is enough to give you lasting protection. So no more re-vaccination after the age of 65!

Check on your vaccination status

If you're not sure what pneumonia vaccine you had, or when, or even whether you ever had one, check your record. Here in Michigan we have the Michigan Care Improvement Registry (MCIR). This registry used to be available only to health professionals, but now you can access your own record. If you're outside of Michigan, or received vaccinations in other states, check with your healthcare provider. It's important to stay up-to-date on all vaccinations. And don't forget, your community pharmacist is there to make sure you get the right vaccination at the right time!

Caution -- nothing ever stays the same!

We're lucky to have vaccine and public health experts who continually re-evaluate information about infection rates and vaccine efficacy. So don't be surprised if the guidelines change again in the future. I'll do my best to keep you updated!

As always, we welcome your comments and questions. Post them below for others to comment on, or contact us directly at BetterMyMeds. We love hearing from you!

 

 

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Betty Chaffee, PharmD, is owner and sole proprietor of BetterMyMeds, a Medication Management service devoted to helping people get the maximum benefit from their medications.
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