Perspective from William Schaffner, MD
August 26, 2014
1 min read

ACIP recommends PCV13 for older adults

Perspective from William Schaffner, MD
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The Advisory Committee on Immunization Practices voted 13-2 to recommend the 13-valent pneumococcal conjugate vaccine, followed by a dose of the 23-valent pneumococcal polysaccharide vaccine, for adults aged at least 65 years who have not previously received a pneumococcal vaccine.

In addition, it recommends that adults aged at least 65 years who have previously received one or more doses of PPSV23 (Pneumovax 23, Merck) should receive a dose of PCV13 (Prevnar 13, Pfizer).

The working group recommends that PCV13 should be given first when possible, and that the interval between the PCV13 followed by PPSV23 should be 6 to 12 months. It also recommends at least a 1-year interval before the PCV13 dose when PPSV23 is given first.

Tamara Pilishvili, MPH, epidemiologist in the CDC’s Respiratory Diseases Branch, presented data from the CAPITA trial, which demonstrated a 75% reduction in vaccine-type invasive pneumococcal disease (IPD) and a 45% reduction in vaccine-type non-bacteremic pneumonia among adults who received PCV13. In addition, the data suggested that the immune response was noninferior, or improved for some serotypes, for PCV13 compared with PPSV23.

“The impact PCV13 will have on the health of older adults depends on how many adults receive the vaccine,” Pilishvili said. “If we can get as many as 30% of adults aged 65 and older vaccinated during 2015, we estimate that around 500 cases of IPD and 15,000 cases of community-acquired pneumonia can be prevented in 1 year.”

The recommendations, which will be published in MMWR when approved by the CDC director, will include guidance on optimal interval spacing of the two vaccines, as well as evidence on administering the vaccines in conjunction with other vaccines recommended for adults.