CDC Advisers Recommend Elderly Receive Both Prevnar and Pneumovax Pneumococcal Vaccines

As seen in the Consultant Connection October 2014 Issue

All adults 65 years of age or older should receive the 13-valent pneumococcal conjugate vaccine (PCV13 - Prevnar) in series with the 23-valent pneumococcal polysaccharide vaccine (PPSV23 - Pneumovax), the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) has decided. The recommended interval between administration of the vaccines depends on the person’s vaccine history and is presented in Morbidity and Mortality Weekly Report (
What was the previous recommendation?
In 2010, ACIP approved recommendations that all persons should be vaccinated with 23-valent pneumococcal polysaccharide vaccine (PPSV23) at age 65 years. In 2012, ACIP made recommendations for use of 13-valent pneumococcal conjugate vaccine (PCV13) and PPSV23 for adults aged ≥19 years with immunocompromising conditions.
Why are the recommendations being modified now?
PCV13 was approved by the Food and Drug Administration in late 2011 for use among adults aged ≥50 years. In June 2014, the results of a randomized placebo-controlled trial showing efficacy of PCV13 against community-acquired pneumonia among approximately 85,000 adults aged ≥65 years became available and were presented to ACIP. The evidence supporting PCV13 vaccination of adults was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation famework and determined to be type 2 (moderate level of evidence); the recommendation was designated as a Category A recommendation, meaning the recommendation applies to all persons in an age- or risk-factor-based group.
What are the new recommendations?
Both PCV13 and PPSV23 should be routinely administered in series to all adults aged ≥65 years. The recommendations for routine PCV13 use among adults aged ≥65 years will be reevaluated in 2018 and revised as needed. ACIP recommendations for routine use of PCV13 in adults aged ≥19 years with immunocompromising conditions, functional or anatomic asplenia, cerebrospinal fluid leak, or cochlear implants remain unchanged. 

Sequential administration and recommended intervals for PCV13 and PPSV23 for adults aged ≥65 years — Advisory Committee on Immunization Practices

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