Pneumovax 23

Pneumovax 23 (PPSV23) is a purified capsular Polysaccharide Antigens from 23 serotypes
These serotypes are responsible for 88% of invasive pneumococcal disease
As of 2024 in U.S, PCV20 and PCV21 have replaced the use of Pneumovax 23 (PPSV23)
1. Dual coverage with PPSV23 is no longer needed with PCV20 and PCV21
2. Dual Immunization with PPSV23 is still needed if PCV13 or PCV15 are given

Dosing regimens are being modified in 2022 by CDC
1. Prevnar 20 is sufficient alone, and does not require Pneumovax
2. GIve Prevnar 20 alone (or Vaxneuvance AND Pneumovax 23)
See Prevnar for dosing Pneumococcal Vaccine schedules
Pneumovax 23 Indications (when Vaxneuvance or Prevnar 13 are used)
1. One dose of Pneumovax 23 is sufficient for most patients at age 65 years
2. Indication for single dose ages 2 to 64 years
  1. See Indications above
  2. Give a second dose at age 65 or at least 5 years after the last dose
3. Indication for 2 doses at more than 5 years apart at ages 2 to 64 years
  1. Give third dose at age 65 years or at least 5 years after the last dose
  2. Chronic renal disease (Renal Failure, Nephrotic Syndrome)
  3. Asplenia
  4. Sickle Cell Anemia
  5. Immunocompromised state
    1. HIV Infection
    2. Leukemia
    3. Lymphoma
    4. Multiple Myeloma
    5. Iatrogenic (e.g. organ transplant, Radiation Therapy, Chemotherapy)

Administer to high risk women before pregnancy
ACIP recommends avoiding in pregnancy
Pneumococcal Vaccine may be given on same day as other Vaccines (e.g. Influenza Vaccine, Shingles Vaccine)
1. Pneumococcal Conjugate Vaccine (e.g. PCV21) may have reduced Antibody response when given with Influenza Vaccine
2. However, given both Vaccines (Prevnar and Influenza) does not reduce their efficacy