September 19, 2014
MMWR: Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal
Polysaccharide Vaccine Among Adults Aged ≥65 Years: Recommendations of the Advisory Committee
on Immunization Practices (ACIP)
Key Points for Adults 65 Years or Older
Summary

Each year in the United States, about 18,000 adults 65 years or older die and thousands more
end up in the hospital because of pneumococcal disease. The best way to prevent
pneumococcal disease is by getting vaccinated.

CDC recommends all adults 65 years or older receive 2 types of pneumococcal vaccines.
o
One dose of PCV13 first, followed 6 to 12 months later by one dose of PPSV23.
o
Learn more about when pneumococcal vaccines are needed for adults:
http://www.cdc.gov/features/adult-pneumococcal.

Pneumococcal vaccines may be available at private doctor offices, public or community health
clinics, or pharmacies.

Most private health insurance covers pneumococcal vaccines and Medicare part B typically
covers the first dose of pneumococcal vaccine.

Talk to your healthcare professional to make sure you are up-to-date on pneumococcal
vaccination, as well as other vaccines that may be recommended for you based on your age,
health condition, job, lifestyle, or other factors.
o
Learn more about vaccines recommended for adults: www.cdc.gov/vaccines/adults.
Recommendation


CDC now recommends 2 pneumococcal vaccines for adults 65 years or older.
o
Pneumococcal conjugate vaccine (PCV13, Prevnar-13®), which protects against 13
strains of pneumococcus bacteria
o
Pneumococcal polysaccharide vaccine (PPSV23, Pneumovax®23), which protects against
23 strains of pneumococcus bacteria
For adults 65 years or older, both vaccines are needed for best protection against pneumococcal
disease.
September 19, 2014

o
Both PCV13 and PPSV23 provide protection against invasive pneumococcal disease,
which includes illnesses like meningitis and bloodstream infections.
o
PCV13 also provides protection against pneumonia.
If you have not had either vaccine before, you should receive a dose of PCV13 first, followed by
a dose of PPSV23, ideally 6 to 12 months later. This also applies to adults who don’t know
whether they have ever received pneumococcal vaccine.
o
If you miss the 6 to 12 month window, you should get PPSV23 next time you see your
healthcare professional.

If you’ve already received any doses of PPSV23, the dose of PCV13 should be given at least 1
year after receipt of the most recent PPSV23 dose.

If you’ve already received a dose of PCV13 at a younger age, another dose of PCV13 is not
recommended.

If you received a dose of pneumococcal vaccine, but don’t know what type, consult with your
clinician about which vaccine is needed. Some information that may be helpful is that PCV13
was not licensed for adults until December 2011, and so any pneumococcal vaccine given before
that time would have been PPSV23.
Where to Get Pneumococcal Vaccines

Pneumococcal vaccines may be available at private doctor offices, public or community health
clinics, or pharmacies.

Check with your doctor or pharmacist or use the Adult Vaccine Finder to help find places that
provide pneumococcal vaccines near you.
Insurance Coverage

Most private health insurance covers pneumococcal vaccines.

At this time, Medicare part B typically covers only the first dose of pneumococcal vaccine for
older adults and pays 100% of the cost of covered pneumococcal vaccines.

Check with your insurance provider for details on whether there is any cost to you and for a list
of in-network vaccine providers.

If you have insurance that supplements Medicare Part B, check with them to see if they cover
both recommended pneumococcal vaccinations.
September 19, 2014
Getting Multiple Vaccines at the Same Visit

PCV13 and PPSV23 should not be given at the same time because it will make them less
effective.
o
You should receive a dose of PCV13 first, followed by a dose of PPSV23, ideally 6 to 12
months later.
o
If you already got PPSV23, then you should get PCV13 at least 1 year after your dose of
PPSV23.

It is safe to get either of the pneumococcal vaccines at the same time as the influenza (flu)
vaccine, but you need to get the two pneumococcal vaccines at different times.

While you don’t need a pneumococcal vaccine every year, it is important to get a flu vaccine
each flu season. Flu can be serious, even for otherwise healthy people. And having the flu
increases your chances of getting pneumococcal disease.
Safety

These vaccines are safe, but side effects can occur.

Most side effects are mild or moderate, meaning they do not affect daily activities.

Common PCV13 side effects include redness, pain, and swelling where the shot is given.
o
Mild fever, fatigue, headache, chills, or muscle pain have also been reported.

Common PPSV23 side effects include redness or pain where the shot is given.

It is safe to receive vaccinations while taking prescription medications.

Vaccines are one of the safest ways to protect your health. If you have questions about
pneumococcal disease or the vaccines to prevent it, talk to your healthcare professional.
Pneumococcal Disease

The best way to prevent pneumococcal disease is by getting vaccinated.

Each year in the United States, about 18,000 adults 65 years or older die and thousands more
end up in the hospital because of pneumococcal disease.

Pneumococcal disease is an infection caused by Streptococcus pneumoniae bacteria, also known
as pneumococcus.
September 19, 2014

Pneumococcal bacteria can cause many types of illnesses that range from mild to very serious.
o
When pneumococcal bacteria spread from the nose and throat to ears or sinuses, it
generally causes mild infections.
o
When the bacteria spread into the blood or lungs, it leads to severe health problems
such as infections of the lungs (pneumonia), blood (bacteremia), and lining of the brain
and spinal cord (meningitis). These illnesses can lead to disability like deafness, brain
damage, or loss of arms or legs. These illnesses can also be life threatening.
o
Some adults are at increased risk for complications from pneumococcal disease,
including

Adults 65 years or older and

Adults 19 years or older with chronic conditions, such as asthma/COPD, heart
disease, and diabetes.

Pneumococcal bacteria spread from person-to-person through coughing or sneezing.

People sometimes have the bacteria in their nose and throat without feeling sick, but can still
spread it to other people.

Learn more about pneumococcal disease at www.cdc.gov/pneumococcal.