The Medical Letter on Drugs and Therapeutics
In Brief: PCV13 for Adults 65 Years and Older
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The US Advisory Committee on Immunization Practices (ACIP) now recommends routine immunization with 13-valent pneumococcal conjugate vaccine (PCV13; Prevnar 13), in addition to the 23-valent pneumococcal polysaccharide vaccine (PPSV23; Pneumovax 23), for all adults ≥65 years old.1

An unpublished, randomized, double-blind trial (CAPiTA) in about 85,000 adults ≥65 years old found that vaccination with PCV13 reduced first episodes of vaccine-type community-acquired pneumonia and invasive pneumococcal disease by 46% and 75%, respectively, compared to placebo.2

Adults ≥65 years old who previously received ≥1 dose of PPSV23 should also receive PCV13, but at least one year after the last dose of PPSV23. For those receiving the pneumococcal vaccine for the first time, PCV13 should be given first, followed 6-12 months later by PPSV23. PCV13 can be given at the same time as an inactivated influenza vaccine. Currently, Medicare only pays for one lifetime dose of a pneumococcal vaccine for healthy patients.

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