Madison Clarke
Pneumococcal disease is a common bacterial cause of respiratory tract infections, bacteremia, and meningitis, and can result in severe morbidity or mortality. The 21-valent pneumococcal conjugate vaccine (PCV21) is a vaccination option for adults aged 18 and above to prevent invasive pneumococcal diseases. PCV21 contains eight serotypes not included in other licensed vaccines, but it does not contain certain serotypes included in other vaccines. The Advisory Committee on Immunization Practices (ACIP) recommends PCV21 as an option for adults aged 19 and above who are recommended to receive either the 15- or 20-valent pneumococcal conjugate vaccine.
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What You'll Learn
PCV21 is recommended for adults aged 18 or 19 and older
Pneumococcal disease is caused by bacteria that can cause mild infections, such as ear infections, and serious infections, such as pneumonia. Streptococcus pneumoniae (pneumococcus) is a common bacterial cause of respiratory tract infections, bacteremia, and meningitis.
In June 2024, the Advisory Committee on Immunization Practices (ACIP) recommended PCV21 as an option for vaccinating adults aged 18 years and older. The US Food and Drug Administration (FDA) approved the use of PCV21 for adults 18 years and older to prevent invasive pneumococcal diseases such as pneumonia, meningitis, and sepsis.
PCV21 is one of three options for vaccinating adults against pneumococcal disease. The other two options are PCV15 followed by 23-valent pneumococcal polysaccharide vaccine (PPSV23) and PCV20. If PPSV23 is not available, one dose of PCV20 or PCV21 may be given. If PCV20 or PCV21 is used, a dose of PPSV23 is not indicated.
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PCV21 is a 21-valent pneumococcal conjugate vaccine
Pneumococcal disease is caused by bacteria that commonly live in the nose and throat and can cause both mild and serious infections. Streptococcus pneumoniae (pneumococcus) is a common bacterial cause of respiratory tract infections, bacteremia, and meningitis. Invasive pneumococcal disease (IPD) is a pneumococcal infection in a normally sterile site (e.g., blood, cerebrospinal fluid, bone, or joint space) that can result in severe morbidity or mortality.
PCV21 contains eight serotypes not included in other licensed vaccines, including PCV15 and PCV20. However, it does not contain certain serotypes that are included in these other vaccines. The specific composition of each vaccine will determine which vaccine is recommended for a particular patient. For example, PCV21 does not contain serotype 4, which has been responsible for a high percentage of IPD cases in certain populations in the Western United States. In these cases, PCV20 alone or PCV15 followed by PPSV23 may be recommended instead of PCV21.
The Advisory Committee on Immunization Practices (ACIP) recommended PCV21 as an option for vaccinating adults in June 2024. The Food and Drug Administration (FDA) approved its use in the same month. The ACIP recommends that all adults aged 65 and older receive a pneumococcal conjugate vaccine, and those aged 19–64 with risk conditions who have not received a PCV or whose vaccination history is unknown. Previously, the options included PCV20 alone or PCV15 followed by PPSV23.
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PCV21 contains eight serotypes not in other vaccines
The Advisory Committee on Immunization Practices (ACIP) recommends pneumococcal vaccination for all adults aged 65 and older, as well as those aged 19–64 with a risk condition who have not received a PCV or whose vaccination history is unknown.
In June 2024, the ACIP recommended PCV21 as an option for adults aged 18 and older. PCV21 is a 21-valent pneumococcal conjugate vaccine that helps prevent invasive pneumococcal diseases such as pneumonia, meningitis, and sepsis.
PCV21 contains eight serotypes not included in other licensed vaccines. It does not contain certain serotypes that are included in other licensed pneumococcal vaccines but adds eight new serotypes. This means that PCV21 does not include antigens for 10 serotypes contained in PCV20 but adds antigens for 11 other serotypes not contained in PCV15 or PCV20.
The addition of PCV21 as a vaccination option is expected to prevent additional disease caused by pneumococcal serotypes unique to PCV21.
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PCV21 is used to prevent invasive pneumococcal diseases
Pneumococcal disease is caused by bacteria that commonly live in the nose and throat and can cause mild infections, such as ear infections, as well as serious infections, such as pneumonia. Streptococcus pneumoniae (pneumococcus) is a common bacterial cause of respiratory tract infections, bacteremia, and meningitis. Invasive pneumococcal disease (IPD), a pneumococcal infection in a normally sterile site (e.g., blood, cerebrospinal fluid, bone, or joint space), can result in severe morbidity or mortality.
The 21-valent pneumococcal conjugate vaccine (PCV21) is used to prevent invasive pneumococcal diseases. PCV21 is recommended for adults aged 18 years and older to prevent invasive pneumococcal diseases such as pneumonia, meningitis, and sepsis. In June 2024, the Advisory Committee on Immunization Practices (ACIP) recommended PCV21 as an option for vaccinating adults. Vaccination against pneumococcal disease was previously recommended for adults 65 years and older and for adults 19 to 64 years of age with an immunocompromising condition or a chronic medical condition that increases the risk of serious pneumococcal disease if infected.
In October 2024, the ACIP voted to reduce the age of routine PCV to 50 years and to continue recommending PCV for adults younger than 50 years with risk conditions. PCV21 is now one of three options for vaccinating adults against pneumococcal disease, the other two being PCV15 followed by a 23-valent pneumococcal polysaccharide vaccine (PPSV23) and PCV20. PCV21 contains eight serotypes not included in other licensed vaccines. The addition of PCV21 as a vaccination option is expected to prevent additional disease caused by pneumococcal serotypes unique to PCV21.
PCV21 does not contain certain serotypes that are included in other licensed pneumococcal vaccines, including serotype 4, which has been responsible for high rates of invasive pneumococcal disease in certain populations. However, PCV21 adds eight new serotypes not included in other vaccines.
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PCV21 is not suitable for everyone
PCV21 is a 21-valent pneumococcal conjugate vaccine that helps prevent invasive pneumococcal diseases such as pneumonia, meningitis, and sepsis. It is recommended for adults aged 18 years and older, particularly those with immunocompromising conditions or chronic medical conditions that increase the risk of pneumococcal infection. However, it is important to note that PCV21 is not suitable for everyone.
Firstly, PCV21 is not suitable for children below the age of 18. The vaccine has been specifically approved for adults and is not recommended for younger individuals. For children, the CDC recommends pneumococcal vaccination for those younger than 5 years old, but this does not include the use of PCV21.
Secondly, PCV21 may not be suitable for certain adults with specific risk factors. While it is recommended for adults with immunocompromising or chronic medical conditions, there are instances where other vaccine options may be more appropriate. For example, PCV21 does not contain serotype 4, which has been a concern for certain populations with high rates of invasive pneumococcal disease due to this serotype. These populations include adults younger than 65 years with a risk condition and a history of substance abuse or homelessness. In such cases, other pneumococcal vaccines that include serotype 4, such as PCV20 or PCV15 with PPSV23, may be more suitable.
Additionally, PCV21 may not be necessary for all older adults. Adults aged 65 and older who have already received pneumococcal vaccinations, such as PCV13 and PPSV23, may not require PCV21. The decision to administer PCV21 in this age group is based on shared clinical decision-making and considers factors such as overall health, risk of pneumococcal disease, and time since the last vaccination.
Moreover, PCV21 may not be suitable for individuals who have previously experienced adverse reactions to the vaccine. In clinical trials, PCV21 recipients reported mild to moderate adverse events such as injection site pain, fatigue, headache, and myalgia. In rare cases, potentially life-threatening adverse events were also reported. Therefore, individuals who have previously experienced adverse reactions to PCV21 or any of its components may be advised to avoid subsequent doses.
Lastly, PCV21 may not be readily available in all locations. The availability of vaccines can vary depending on region and distribution channels. In some cases, alternative pneumococcal vaccines, such as PCV20 or PCV15, may be offered if PCV21 is not accessible.
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Frequently asked questions
The Advisory Committee on Immunization Practices (ACIP) recommends pneumococcal vaccination for all adults aged ≥65 years, as well as adults aged 19–64 years with certain risk conditions for pneumococcal disease if they have not received a PCV or their vaccination history is unknown.
PCV21 is a 21-valent pneumococcal conjugate vaccine. It contains eight serotypes not included in other licensed vaccines.
PCV21 is used to prevent pneumococcal disease, including pneumonia, meningitis, and sepsis.
Yes, there are two other pneumococcal conjugate vaccines that are licensed and recommended for use in the United States: PCV15 and PCV20.
