New Pneumonia Vaccine Gets CDC Nod: Should You Get It?

Come this fall, some adults may be rolling up their sleeves to receive an additional vaccine to go with their COVID-19, flu, and RSV shots.

The Centers for Disease Control and Prevention (CDC) recently updated their vaccine recommendations to include the new pneumococcal 21-valent conjugate vaccine (PCV21) as an option for high-risk individuals.

PCV21 was approved in June for adults 18 and older to protect against invasive pneumoccocal disease. This infection can cause contagious and potentially severe illness, such as pneumonia, meningitis, and sepsis.

What Is PCV21 and What’s the Difference From Other Pneumonia Vaccines?

The new inoculation, manufactured by Merck under the name Capvaxive, targets distinct groups of pneumococcal bacteria (serotypes) responsible for about 84 percent of invasive pneumococcal disease in adults age 50 and older.

The shot includes eight unique serotypes not covered by other currently approved pneumococcal vaccines — those serotypes were responsible for about 27 percent of invasive pneumococcal disease cases in adults age 50 and older and about 30 percent in adults age 65 and old, according to Merck.

The CDC recommendation follows the recent approval of the vaccine by the U.S. Food and Drug Administration, which was based on four clinical trials demonstrating robust immune responses in different adult populations.

Why Pneumonia Vaccines Matter

Pneumococcal bacteria can cause serious and often life-threatening illnesses. About 150,000 people in the United States are hospitalized each year with pneumococcal pneumonia, and between 7,500 and 10,500 of them die, according to the National Foundation for Infectious Diseases. The death rate is even higher among adults 65 years and older, as well as for people with underlying health conditions.

Other infections are less common, but more deadly. Pneumococcal meningitis kills about 1 in 6 older patients who are infected; and blood infection kills about 1 in 8 adults who get it.

The CDC stresses that vaccination is the best way to protect against serious pneumococcal infections.

“Pneumococcal disease is a leading killer of older people and if you don’t get vaccinated, you’re at increased risk that it could be a life-ending event,” says internist Sandra Fryhofer, MD, the American Medical Association’s liaison to the CDC’s Advisory Committee on Immunization Practices, which unanimously recommended the new Capaxive vaccine.

The side effects from vaccination (such as injection site pain, fatigue, and headache) are minimal, and the benefits far outweigh the risks. says Fryhofer, who is also adjunct associate professor of medicine at Emory University School of Medicine in Atlanta, and is on staff at several Emory Healthcare hospitals.

Who Should Consider PCV Vaccination

This latest vaccine is recommended as an option for adults age 65 and older who have not previously received a pneumococcal conjugate vaccine or whose previous vaccination history is unknown.

Individuals ages 19 to 64 with certain risk factors, certain underlying medical conditions — such as heart disease, lung disease, diabetes, kidney disease, or liver disease — are urged to get the shot as well.

The immunization is also advised as an option for adults age 19 and up who have been previously vaccinated with other pneumococcal vaccines — specifically those who have started their pneumococcal vaccine series with PCV13 (pneumococcal 13-valent conjugate vaccine) but have not received all recommended PPSV23 (pneumococcal 23-valent polysaccharide vaccine) doses.

What Are the Advantages of the New Vaccine?

Is this new vaccination better than pneumococcal vaccines that have come before?

That’s a “complicated question,” according to Michael Niederman, MD, a pulmonary and critical care medicine specialist at NewYork-Presbyterian/Weill Cornell Medical Center, whose research has focused on preventing infections associated with pneumococcal disease.

“The trouble with comparing different vaccines is that they cover different strains,” he says.

Prevnar20 (pneumococcal 20-valent conjugate vaccine) from Pfizer has been a leading vaccination for adults. While PCV21 covers just one more strain than PCV20, the comparison is more than a matter of numbers.

When it comes to preventing pneumococcal illness, Prevnar20 targets a little over half of likely strains but Capvaxive covers slightly more than 80 percent, according to Dr. Niederman.

“The choice of vaccine depends a lot on your risk factors,” he says. “If you’re a high-risk person for invasive pneumococcal infection, you get better coverage with PCV21, but there is one invasive strain that’s covered by PCV20 that’s not covered by PCV21, so there’s compromises in any choice.”

Dr. Fryhofer adds that PCV21 can also be an option for those who have received earlier versions of pneumococcal vaccination.

“If you’re 65 or older and five years out from getting an earlier combination pneumococcal vaccine series [PCV13 plus PPSV23], you have the option of getting either PCV20 or now PCV21,” she says. Even if you’ve received PCV20, you might be advised to get PCV21 depending on how high-risk you are.

Because pneumococcal vaccine recommendations can be complicated, Fryhofer advises patients to get direction from their healthcare provider and stay up to date with the latest CDC immunization schedules.

Having the flu increases the risk of getting pneumococcal disease so protection against the illness is especially important during flu season, according to the National Foundation for Infectious Diseases.

If both vaccines are due, they can be administered during the same healthcare visit.

Capaxive will be available in the United States by late summer, according to a spokesperson from Merck. Out-of-pocket costs individuals will pay depend on their specific insurance plans and coverage. Historically when the CDC endorses a vaccine, insurance plans are more likely to cover costs.