What’s the difference between the PCV13 and PPSV23 vaccines, and who do I give them to?

PCV13 and PPSV23 are two Pneumococcus vaccines. They are important for helping prevent pneumonia, as well as other diseases caused by Pneumococcus, like bacteremia, meningitis, etc.

To clarify: PCV13 is called Prevnar and is made by Pfizer. PPSV23 is called Pneumovax and is made by Merck.

It is worth noting that babies get the PCV13 vaccine. If they are mistakenly given Pneumovax, they should get Prevnar as soon as possible because Pneumovax is not effective in kids <24 months.

ALL adults >65 should get BOTH pneumonia vaccines–just not at the same visit. Evidence shows that it’s best to give the PCV13 first and then the PPSV23 6-12 months later for better immunity (2 months if they have HIV or asplenia). PPSV23 is only 60-80% effective…but that’s still better than nothing.

Adults ages 19-64 should get the PCV13 if they are at risk for pneumococcal infection:

  • immunocompromised patients (HIV, malignancy, on steroids, etc)
  • Cochlear implant
  • CSF leak
  • asplenia

Human beings ages 2-64 should get the PPSV23 if they are at risk for pneumococcal disease:

  • patient groups listed above
  • chronic cardiovascular disease like CHF, cardiomyopathy
  • chronic respiratory disease like COPD, asthma
  • chronic liver disease, like cirrhosis
  • chronic renal failure
  • smokers >19 years of age
  • significant ETOH use
  • organ transplant patients

Here’s where it gets tricky: if someone got their first PPSV23 before age 65, they should get a SECOND dose 5 years after the first one. They should get a THIRD dose once they turn 65. But once they are 65, they don’t need any additional doses even if they have a risk factor and didn’t get one when they were younger.


3 thoughts on “What’s the difference between the PCV13 and PPSV23 vaccines, and who do I give them to?

  1. Hi Cynthia, thanks for pointing that out–this post was intended to give a quick review of timing of vaccine administration, since the guidelines have changed a couple of times. The biological difference is that the PCV13 vaccine is a conjugated vaccine and as the name suggests, is protective against 13 strains of Pneumococcus, while PPSV23 is a polysaccharide vaccine that has expanded coverage to 23 strains. Conjugated vaccines, because they induce a T cell response, tend to be “stronger.” Hope that helps!


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