Pneumococcal Vaccination Recommendations

Current Recommendations

The Centers for Disease Control and Prevention recommends shared clinical decision-making for adults who have completed their recommended pneumococcal vaccine series with both PCV13 and PPSV23, regarding administration of PCV20 at least 5 years after the last pneumococcal vaccine dose 1
A single dose of PCV20 should be given at least 5 years after the last pneumococcal vaccine dose, based on clinical trial data showing that PCV20 is safe and immunogenic in adults who previously received both PCV13 and PPSV23 1
Underlying medical conditions that increase risk for pneumococcal disease should be considered in shared decision-making, as well as time since last pneumococcal vaccination and risk of exposure to pneumococcal serotypes 1

Conjugate vaccines, like PCV20, induce a T-cell dependent response, creating memory B-cells, while polysaccharide vaccines, like PPSV23, induce a T-cell independent response without memory B-cell creation 2
Economic models showed variable cost-effectiveness for additional PCV20 vaccination after complete series, ranging from $93,000 to $970,000 per QALY gained 1

The National Comprehensive Cancer Network recommends PCV20 for cancer patients who are pneumococcal vaccine-naïve, and for those with prior vaccination history, follow the same recommendations as the general population based on previous vaccine receipt 5
Adults with immunocompromising conditions who have received both PCV13 and PPSV23 may benefit from PCV20 administered ≥5 years after the last pneumococcal vaccine dose, with economic models showing variable results, from $40,000 per QALY gained to potentially worse health outcomes [3] [4]

The cost-effectiveness of additional vaccination varies significantly based on time since previous vaccination and individual risk factors, with economic models showing a range of $93,000 to $970,000 per QALY gained 1