Prevnar 20 (Pneumococcal 20-valent Conjugate Vaccine)

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Recommendations

Now recommended by NACI

NACI recommends the pneumococcal conjugate vaccine Prevnar 20 to:¹

NACI: National Advisory Committee on Immunization.

For those previously vaccinated with PNEU-C-13 alone or followed by PNEU-P-23, please consult the NACI recommendations. Please consult the Product Monograph for authorized use.

What are the recommendations for adults 18–49 years old with
non-immunocompromising risk factors?

At this time there are no public health level recommendations on the use of Prevnar 20 for adults 18–49 years old with non-immunocompromising risk factors that place them at high risk of IPD as additional analyses on the cost-effectiveness of Prevnar 20 in this population are needed. Prevnar 20 may be considered at clinical discretion for this population.¹

Consider offering Prevnar 20 to your adult patients, as per NACI’s recommendation.

Visit the NACI website for the most current statements on pneumococcal vaccines.

Factors placing patients at higher risk of pneumococcal disease¹

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Non-immunocompromising conditions	Immunocompromising conditions*	Other risk factors
Chronic cerebrospinal fluid (CSF) leak Chronic neurologic condition that may impair clearance of oral secretions Cochlear implants, including children and adults who are to receive implants Chronic heart disease Diabetes mellitus Chronic kidney disease* Chronic liver disease, including hepatic cirrhosis due to any cause* Chronic lung disease, including asthma requiring medical care in the preceding 12 months	Sickle cell disease, congenital or acquired asplenia, or splenic dysfunction† Congenital immunodeficiencies involving any part of the immune system, including B-lymphocyte (humoral) immunity, T-lymphocyte (cell) mediated immunity, complement system (properdin, or factor D deficiencies), or phagocytic functions Immunocompromising therapy, including use of long-term corticosteroids, chemotherapy, radiation therapy, and post-organ transplant therapy HIV infection Hematopoietic stem cell transplant (recipient)‡ Malignant neoplasms, including leukemia and lymphoma Nephrotic syndrome Solid organ or islet transplant	Individuals who smoke who use illicit drugs with alcohol use disorder who are experiencing homelessness who live in communities or settings§ experiencing sustained high rates of invasive pneumococcal disease

Conditions considered to result in the highest risk of IPD

Generally, asplenia (functional or anatomic), sickle cell disease and other hemoglobinopathies are not considered immunocompromising conditions, but for the purposes of pneumococcal vaccine recommendations they are included in this category

HSCT recipients have specific pneumococcal vaccination recommendations

Can include long-term care facilities

Prevnar 20 is indicated for active immunization for the prevention of pneumonia and invasive pneumococcal disease (including sepsis, meningitis, bacteremic pneumonia, pleural empyema and bacteremia) in adults 18 years of age and older caused by Streptococcus pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 8, 9V, 10A, 11A, 12F, 14, 15B, 18C, 19A, 19F 22F, 23F and 33F.²

Relevant warnings and precautions:

Immunocompromised individuals may have a reduced antibody response to the vaccine.²
Safety and immunogenicity data on Prevnar 20 are not available for individuals in certain immunocompromised groups (e.g., those with malignancy or nephrotic syndrome) and vaccination should be considered on an individual basis. Some safety and immunogenicity data are available in individuals with sickle cell disease, HIV infection, or hematopoietic stem cell transplant.²
The administration of Prevnar 20 should be postponed in individuals with acute severe febrile illness.²
As with any intramuscular injection, Prevnar 20 should be given with caution in individuals with thrombocytopenia or any coagulation disorder, or receiving anticoagulant therapy.²
May not protect all individuals from pneumococcal disease.²

For more information:

Please consult the Product Monograph for important information relating to adverse reactions, drug interactions, and dosing information, which have not been discussed in this piece. The Product Monograph is also available on request by calling 1-800-463-6001.

References:

An Advisory Committee Statement (ACS) National Advisory Committee on Immunization (NACI) Public health level recommendations on the use of pneumococcal vaccines in adults, including the use of 15-valent and 20-valent conjugate vaccines (Advanced copy). October 2022. 

Prevnar 20 Product Monograph. Pfizer Canada ULC. 2022.

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Pneumococcal disease

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