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Pneumococcal conjugate vaccine (15-valent) (PCV15): Drug information

Pneumococcal conjugate vaccine (15-valent) (PCV15): Drug information
(For additional information see "Pneumococcal conjugate vaccine (15-valent) (PCV15): Patient drug information" and see "Pneumococcal conjugate vaccine (15-valent) (PCV15): Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Brand Names: US
  • Vaxneuvance
Brand Names: Canada
  • Vaxneuvance
Pharmacologic Category
  • Vaccine;
  • Vaccine, Inactivated (Bacterial)
Dosing: Adult

Note: According to the ACIP, doses administered ≤4 days before minimum interval or age are considered valid; however, local or state mandates may supersede this timeframe (ACIP [Kroger 2023]).

Pneumococcal disease prevention

Pneumococcal disease prevention: CDC/ACIP recommendations: PCV15: IM: 0.5 mL as a single dose; see the following recommendations based on age, prior pneumococcal vaccination, and comorbid conditions/risk factors (CDC/ACIP [Kobayashi 2023]). For additional guidance, the CDC recommends using the PneumoRecs VaxAdvisor (mobile app or web version: https://www2a.cdc.gov/vaccines/m/pneumo/agegroup.html).

Pneumococcal Vaccination for Patients 19 to 64 Years of Age with Certain Chronic Health Conditions or Other Risk Factorsa,b

Prior pneumococcal vaccination

Option Ac

Option Bd

a Includes alcohol use disorder, chronic heart/liver/lung disease, cigarette smoking, diabetes mellitus.

b Vaccine abbreviations: Pneumococcal conjugate vaccine 20-valent = PCV20; Pneumococcal conjugate vaccine 15-valent = PCV15; Pneumococcal conjugate vaccine 13-valent = PCV13; Pneumococcal polysaccharide vaccine 23-valent = PPSV23. Refer to individual monographs for additional information.

c PCV20 available.

d PCV15 and PPSV23 available.

e Also applies to patients who previously received PCV7 (at any age) but no other pneumococcal vaccines or unknown vaccination status.

f Review recommendations again when patient turns 65 years of age.

Nonee

PCV20

PCV15 followed by PPSV23 ≥1 year later

PPSV23 only

PCV20 administered ≥1 year later

PCV15 administered ≥1 year later

PCV13 only

PCV20 administered ≥1 year later

PPSV23 administered ≥1 year laterf

PCV13 and PPSV23

No additional pneumococcal vaccine at this time.f

PCV15 only

PPSV23 ≥1 year later

PCV20 only

No additional pneumococcal vaccine at this time.

Pneumococcal Vaccination for Patients 19 to 64 Years of Age with Specified Immunocompromising Conditionsa,b

Prior pneumococcal vaccination

Option Ac

Option Bd

a Includes asplenia (congenital or acquired), chronic renal failure, generalized malignancy, HIV infection, Hodgkin disease, immunodeficiencies (congenital or acquired), immunosuppression (iatrogenic, including immunosuppressive therapies), leukemia, lymphoma, multiple myeloma, nephrotic syndrome, sickle cell disease and other hemoglobinopathies, solid organ transplant. Excludes hematopoietic cell transplant (HCT).

b Vaccine abbreviations: Pneumococcal conjugate vaccine 20-valent = PCV20; Pneumococcal conjugate vaccine 15-valent = PCV15; Pneumococcal conjugate vaccine 13-valent = PCV13; Pneumococcal polysaccharide vaccine 23-valent = PPSV23. Refer to individual monographs for additional information.

c PCV20 available.

d PCV15 and PPSV23 available.

e Also applies to patients who previously received PCV7 (at any age) but no other pneumococcal vaccines or unknown vaccination status.

f Review recommendations again when patient turns 65 years of age.

Nonee

PCV20

PCV15 followed by PPSV23 ≥8 weeks later

PPSV23 only

PCV20 administered ≥1 year later

PCV15 administered ≥1 year later

PCV13 only

PCV20 administered ≥1 year later

PPSV23 administered ≥8 weeks later followed by another PPSV23 dose ≥5 years laterf

PCV13 and 1 dose of PPSV23

PCV20 administered ≥5 years later

PPSV23 administered ≥5 years laterf

PCV13 and 2 doses of PPSV23

PCV20 administered ≥5 years later

No additional pneumococcal vaccine at this timef

PCV15 only

PPSV23 administered ≥8 weeks later

PCV20 only

No additional pneumococcal vaccine at this time.

Pneumococcal Vaccination for Patients 19 to 64 Years of Age with a Cochlear Implant or Cerebrospinal Fluid Leaka

Prior pneumococcal vaccination

Option Ab

Option Bc

a Vaccine abbreviations: Pneumococcal conjugate vaccine 20-valent = PCV20; Pneumococcal conjugate vaccine 15-valent = PCV15; Pneumococcal conjugate vaccine 13-valent = PCV13; Pneumococcal polysaccharide vaccine 23-valent = PPSV23. Refer to individual monographs for additional information.

b PCV20 available.

c PCV15 and PPSV23 available.

d Also applies to patients who previously received PCV7 (at any age) but no other pneumococcal vaccines or unknown vaccination status.

e Review recommendations again when patient turns 65 years of age.

Noned

PCV20

PCV15 followed by PPSV23 ≥8 weeks later

PPSV23 only

PCV20 administered ≥1 year later

PCV15 administered ≥1 year later

PCV13 only

PCV20 administered ≥1 year later

PPSV23 administered ≥8 weeks latere

PCV13 and 1 dose of PPSV23

PCV20 administered ≥5 years later

No additional pneumococcal vaccine at this timee

PCV15 only

PPSV23 administered ≥8 weeks latere

PCV20 only

No pneumococcal vaccine at this time.

Pneumococcal Vaccination for Patients ≥19 Years of Age after HCTa,b

Prior pneumococcal vaccination

Option Ac

Option Bd

a Vaccine abbreviations: Pneumococcal conjugate vaccine 20-valent = PCV20; Pneumococcal conjugate vaccine 15-valent = PCV15; Pneumococcal conjugate vaccine 13-valent = PCV13; Pneumococcal polysaccharide vaccine 23-valent = PPSV23. Refer to individual monographs for additional information.

b Four doses of a pneumococcal vaccine after HCT are needed to complete the series.

c PCV20 available.

d PCV15 and PPSV23 available.

e Whichever time point is later; consult with transplant providers for optimal timing.

None after HCT

Three doses of PCV20 administered 4 weeks apart beginning 3 to 6 months after HCT; administer fourth dose of PCV20 ≥6 months after third dose of PCV20 or ≥1 year from HCTe

Three doses of PCV15 administered 4 weeks apart beginning 3 to 6 months after HCT, followed by PPSV23 ≥1 year from HCT (administer PCV15 in place of PPSV23 if patient has chronic GVHD).

1 dose of PCV13 or PCV 15 after HCT

Two doses of PCV20 administered 4 weeks apart beginning 4 weeks after last PCV13 or PCV15 dose;administer third dose of PCV20 ≥6 months after second dose of PCV20 or ≥1 year from HCTe

Two doses of PCV15 administered 4 weeks apart beginning 4 weeks after last PCV13 or PCV15 dose; administer PPSV23 ≥1 year from HCT (administer PCV15 in place of PPSV23 if patient has chronic GVHD).

2 doses of PCV13 or PCV 15 after HCT

PCV20 administered 4 weeks after last PCV13 or PCV15 dose; administer second dose of PCV20 ≥6 months after first dose of PCV20 or ≥1 year from HCTe

PCV15 administered 4 weeks after last PCV13 or PCV15 dose, followed by PPSV23 ≥1 year from HCT (administer PCV15 in place of PPSV23 if patient has chronic GVHD).

3 doses of PCV13 or PCV 15 after HCT

PCV20 administered ≥6 months after last dose of PCV13 or PCV15 or ≥1 year from HCTe

PPSV23 ≥1 year from HCT (administer PCV15 in place of PPSV23 if patient has chronic GVHD).

Canadian recommendations: The Canadian National Advisory Committee on Immunization (NACI) provides different recommendations as compared to the CDC; see NACI recommendations for details.

Dosing: Kidney Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Older Adult

Pneumococcal disease prevention:

CDC/ACIP recommendations: Adults ≥65 years of age: PCV15: IM: 0.5 mL as a single dose; see the following recommendations based prior pneumococcal vaccination and comorbid conditions/risk factors (CDC/ACIP [Kobayashi 2023]). For additional guidance, the CDC recommends using the PneumoRecs VaxAdvisor (mobile app or web version: https://www2a.cdc.gov/vaccines/m/pneumo/agegroup.html).

Pneumococcal Vaccination for Older Adultsa

Prior pneumococcal vaccination

Option Ab

Option Bc

a Vaccine abbreviations: Pneumococcal conjugate vaccine 20-valent = PCV20; Pneumococcal conjugate vaccine 15-valent = PCV15; Pneumococcal conjugate vaccine 13-valent = PCV13; Pneumococcal polysaccharide vaccine 23-valent = PPSV23. Refer to individual monographs for additional information.

b PCV20 available.

c PCV15 and PPSV23 available.

d Also applies to patients who previously received PCV7 at any age but no other pneumococcal vaccines.

e Consider shorter interval (minimum of 8 weeks) for those with an immunocompromising condition, cochlear implant, or cerebrospinal fluid (CSF) leak.

f For adults with an immunocompromising condition, cochlear implant, or CSF leak, the minimum interval for PPSV23 is ≥8 weeks since last PCV13 dose and ≥5 years since last PPSV23 dose.

Noned

PCV20

PCV15 followed by PPSV23 ≥1 year latere

PPSV23 only (at any age)

PCV20 administered ≥1 year later

PCV15 administered ≥1 year later

PCV13 only (at any age)

PCV20 administered ≥1 year later

PPSV23 administered ≥1 year latere

PCV13 (at any age) and PPSV23 at <65 years of age

PCV20 administered ≥5 years after last pneumococcal vaccination

PPSV23 administered ≥1 year after PCV13 and ≥5 years after last PPSV23f

PCV13 (at any age) and PPSV23 at ≥65 years of age

May administer PCV20 ≥5 years after last pneumococcal vaccine (per shared clinical decision-making)

PCV15

PPSV23 administered ≥1 year latere

PCV20

No additional pneumococcal vaccine at this time.

Canadian recommendations: The Canadian National Advisory Committee on Immunization (NACI) provides different recommendations as compared to the CDC; see NACI recommendations for details.

Dosing: Pediatric

(For additional information see "Pneumococcal conjugate vaccine (15-valent) (PCV15): Pediatric drug information")

Dosage guidance:

Dosing: According to the Advisory Committee on Immunization Practices (ACIP), doses administered ≤4 days before minimum interval or age are considered valid; however, local or state mandates may supersede this timeframe (ACIP [Kroger 2023]).

Pneumococcal disease prevention

Pneumococcal disease prevention:

Note: Number and timing of doses depends on age when series initiated, previous receipt of other pneumococcal conjugate vaccines (PCVs), and presence of conditions that increase the risk for pneumococcal disease. For details, see ACIP recommendations (CDC/ACIP [Farrar 2023]).

Infants ≥6 weeks and Children <2 years: Note: A series started with pneumococcal conjugate vaccine 13-valent (PCV13) may be completed with pneumococcal conjugate vaccine 15-valent (PCV15) or pneumococcal conjugate vaccine 20-valent (PCV20) without restarting the series (CDC/ACIP [Farrar 2023]; manufacturer's labeling).

First dose at 2 months of age: IM: 0.5 mL per dose for a total of 4 doses given at 2, 4, 6, and 12 through 15 months of age. The first dose may be given as young as 6 weeks of age; doses should be administered ≥8 weeks apart (CDC/ACIP [Farrar 2023]; manufacturer's labeling).

Catch-up dosing: Note: If the initial PCV dose is not administered before 6 months of age, the number of doses for series completion and timing varies.

First dose at 7 to <12 months of age: IM: 0.5 mL per dose for a total of 3 doses; administer the second dose ≥4 weeks after the first; administer the third dose ≥8 weeks after the second dose and after the first birthday (ACIP/CDC [Farrar 2023]; ACIP/CDC [Kobayashi 2022]; manufacturer's labeling).

First dose at 12 months to <2 years of age: IM: 0.5 mL per dose for 2 doses administered ≥8 weeks apart (ACIP/CDC [Farrar 2023]; ACIP/CDC [Kobayashi 2022]; manufacturer's labeling).

Children ≥2 years and Adolescents:

Patients WITHOUT any conditions that increase the risk for pneumococcal disease (ie, healthy children) with an incomplete PCV status:

Children 2 to <5 years: IM: 0.5 mL as a single dose (ACIP/CDC [Farrar 2023]); manufacturer's labeling).

Children ≥5 years and Adolescents: IM: ACIP does not recommend use of PCV15 in healthy children in this age group; however, the manufacturer's labeling allows a single 0.5 mL dose to be administered to patients <18 years of age who have never received a PCV (ACIP/CDC [Farrar 2023]); manufacturer's labeling).

Patients WITH any condition that increases the risk for pneumococcal disease:

Children 2 to <6 years:

Patients who received <3 doses of any PCV by 2 years of age: IM: 0.5 mL per dose for 2 doses separated by ≥8 weeks (ACIP/CDC [Farrar 2023]; ACIP/CDC [Kobayashi 2022]).

Patients who received 3 doses of any PCV prior to 12 months of age: IM: 0.5 mL as a single dose ≥8 weeks after the last PCV dose (ACIP/CDC [Farrar 2023]).

Children ≥6 years and Adolescents:

Patients who have not received any dose of PCV: IM: 0.5 mL per dose as a single dose (CDC/ACIP [Farrar 2023]).

Dosing: Kidney Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Reported adverse reactions are for infants, children, adolescents, and adults, unless otherwise indicated.

>10%:

Gastrointestinal: Decreased appetite (infants, children <2 years: 14% to 23%; children ≥2 years, adolescents: 2%)

Local: Erythema at injection site (8% to 28%), induration at injection site (infants, children, adolescents: 7% to 17%), pain at injection site (19% to 76%), swelling at injection site (11% to 22%)

Nervous system: Drowsiness (infants, children <2 years: 22% to 48%; children ≥2 years, adolescents: 3%), fatigue (children, adolescents, adults: 16% to 34%), headache (children, adolescents, adults: 12% to 27%), irritability (infants, children <2 years: 33% to 63%; children ≥2 years, adolescents: 3%)

Neuromuscular & skeletal: Arthralgia (adults: 6% to 13%), myalgia (children, adolescents, adults: 16% to 29%)

Miscellaneous: Fever (infants and children <2 years: 11% to 22%; children ≥2 years, adolescents, adults: ≤4%)

1% to 10%:

Dermatologic: Urticaria (infants, children, adolescents: 1% to 3%)

Local: Injection-site pruritus (adults: 3%)

<1%:

Local: Urticaria at injection site (infants, children <2 years)

Nervous system: Febrile seizure (infants)

Frequency not defined: Respiratory: Apnea (premature infants)

Contraindications

Severe hypersensitivity (eg, anaphylaxis) to pneumococcal conjugate vaccine, any component of the formulation, or to diphtheria toxoid.

Warnings/Precautions

Concerns related to adverse effects:

• Anaphylactoid/hypersensitivity reactions: Immediate treatment (including epinephrine 1 mg/mL) for anaphylactoid and/or hypersensitivity reactions should be available during vaccine use (ACIP [Kroger 2023]).

• Shoulder injury related to vaccine administration: Vaccine administration that is too high on the upper arm may cause shoulder injury (eg, shoulder bursitis, tendinopathy) resulting in shoulder pain and reduced range of motion following injection. Use proper injection technique for vaccines administered in the deltoid muscle (eg, injecting in the central, thickest part of the muscle) to reduce the risk of shoulder injury related to vaccine administration (Cross 2016; Foster 2013).

• Syncope: Syncope has been reported with use of injectable vaccines and may result in serious secondary injury (eg, skull fracture, cerebral hemorrhage); typically reported in adolescents and young adults and within 15 minutes after vaccination. Procedures should be in place to avoid injuries from falling and to restore cerebral perfusion if syncope occurs (ACIP [Kroger 2023]).

Disease-related concerns:

• Acute illness: The decision to administer or delay vaccination because of current or recent febrile illness depends on the severity of symptoms and the etiology of the disease. Postpone administration in patients with moderate or severe acute illness (with or without fever); vaccination should not be delayed for patients with mild acute illness (with or without fever) (ACIP [Kroger 2023]).

• Bleeding disorders: Use with caution in patients with bleeding disorders (including thrombocytopenia); bleeding/hematoma may occur from IM administration; if the patient receives antihemophilia or other similar therapy, IM injection can be scheduled shortly after such therapy is administered (ACIP [Kroger 2023]).

Concurrent drug therapy issues:

• Anticoagulant therapy: Use with caution in patients receiving anticoagulant therapy; bleeding/hematoma may occur from IM administration (ACIP [Kroger 2023]).

• Vaccines: To maximize vaccination rates, the Advisory Committee on Immunization Practices (ACIP) recommends simultaneous administration (ie, >1 vaccine on the same day at different anatomic sites) of all age-appropriate vaccines (live or nonlive) for which a person is eligible at a single visit, unless contraindications exist (ACIP [Kroger 2023]).

Special populations:

• Altered immunocompetence: Postpone vaccination during periods of severe immunosuppression (eg, patients receiving chemo-/radiation therapy or other immunosuppressive therapy [including high-dose corticosteroids]) if appropriate; may have a reduced response to vaccination. In general, household and close contacts of persons with altered immunocompetence may receive all age-appropriate vaccines (ACIP [Kroger 2023]; IDSA [Rubin 2014]). Nonlive vaccines should be administered ≥2 weeks prior to planned immunosuppression when feasible; nonlive vaccines administered during chemotherapy should be readministered after immune competence is regained (ACIP [Kroger 2023]; IDSA [Rubin 2014]).

• Premature infants: Apnea following IM vaccination has been observed in some preterm infants; consider clinical status implications.

Other warnings/precautions:

• Antipyretics: Antipyretics have not been shown to prevent febrile seizures; antipyretics may be used to treat fever or discomfort following vaccination (ACIP [Kroger 2023]). One study reported that routine prophylactic administration of acetaminophen prior to vaccination to prevent fever decreased the immune response of some vaccines; the clinical significance of this reduction in immune response has not been established (Prymula 2009).

• Appropriate use: Specific recommendations for use of vaccines in immunocompromised patients with asplenia, cancer, HIV infection, cerebrospinal fluid leaks, cochlear implants, hematopoietic stem cell transplant (prior to or after), sickle cell disease, solid organ transplant (prior to or after), or those receiving immunosuppressive therapy for chronic conditions are available from the Infectious Diseases Society of America (IDSA [Rubin 2014]).

• Effective immunity: Vaccination may not result in effective immunity in all patients. Response depends upon multiple factors (eg, type of vaccine, age of patient) and may be improved by administering the vaccine at the recommended dose, route, and interval (ACIP [Kroger 2023]).

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Suspension Prefilled Syringe, Intramuscular:

Vaxneuvance: 2 mcg each of capsular polysaccharide for serotypes 1, 3, 4, 5, 6A, 7F, 9V, 14, 18C, 19A, 19F, 22F, 23F, and 33F, and 4 mcg of capsular polysaccharide for serotype 6B [conjugated to CRM197 protein 30 mcg] per 0.5 mL (0.5 mL)

Generic Equivalent Available: US

No

Pricing: US

Suspension Prefilled Syringe (Vaxneuvance Intramuscular)

0.5 mL (per 0.5 mL): $266.91

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Suspension Prefilled Syringe, Intramuscular:

Vaxneuvance: 2 mcg each of capsular polysaccharide for serotypes 1, 3, 4, 5, 6A, 7F, 9V, 14, 18C, 19A, 19F, 22F, 23F, and 33F, and 4 mcg of capsular polysaccharide for serotype 6B [conjugated to CRM197 protein 30 mcg] per 0.5 mL (0.5 mL)

Administration: Adult

IM: Hold syringe horizontally and shake well prior to use; do not use if an opalescent suspension does not form. Administer IM into the deltoid muscle (ACIP [Kroger 2023]). Use proper injection technique in the deltoid muscle (eg, injecting in the central, thickest part of the muscle) to reduce the risk of shoulder injury related to vaccine administration (Cross 2016; Foster 2013). Do not mix with other vaccines or injections; separate needles and syringes should be used for each injection. To prevent syncope-related injuries, patients should be vaccinated while seated or lying down (ACIP [Kroger 2023]). US law requires that the date of administration, the vaccine manufacturer, lot number of vaccine, Vaccine Information Statement edition date and date it was provided, and the administering person's name, title, and address be recorded.

For patients at risk of hemorrhage following IM injection, the vaccine should be administered IM if, in the opinion of the physician familiar with the patient's bleeding risk, the vaccine can be administered by this route with reasonable safety. If the patient receives antihemophilia or other similar therapy, IM vaccination can be scheduled shortly after such therapy is administered. A fine needle (≤23-gauge) can be used for the vaccination and firm pressure applied to the site (without rubbing) for at least 2 minutes. The patient should be instructed concerning the risk of hematoma from the injection. Patients on anticoagulant therapy should be considered to have the same bleeding risks and treated as those with clotting factor disorders (ACIP [Kroger 2023]).

Administration: Pediatric

Parenteral: IM: Hold syringe horizontally and shake well prior to use; do not use if an opalescent suspension does not form. Administer IM into the anterolateral thigh or deltoid muscle, as appropriate for age (ACIP [Kroger 2023]). Use proper injection technique in the deltoid muscle (eg, injecting in the central, thickest part of the muscle) to reduce the risk of shoulder injury related to vaccine administration (Cross 2016; Foster 2013). Do not mix with other vaccines or injections; separate needles and syringes should be used for each injection. To prevent syncope-related injuries, adolescents should be vaccinated while seated or lying down (ACIP [Kroger 2023]). US law requires that the date of administration, the vaccine manufacturer, lot number of vaccine, Vaccine Information Statement edition date and date it was provided, and the administering person's name, title, and address be recorded.

For patients at risk of hemorrhage following IM injection, the vaccine should be administered IM if, in the opinion of the physician familiar with the patient's bleeding risk, the vaccine can be administered by this route with reasonable safety. If the patient receives antihemophilia or other similar therapy, IM vaccination can be scheduled shortly after such therapy is administered. A fine needle (≤23-gauge) can be used for the vaccination and firm pressure applied to the site (without rubbing) for at least 2 minutes. The patient should be instructed concerning the risk of hematoma from the injection. Patients on anticoagulant therapy should be considered to have the same bleeding risks and treated as those with clotting factor disorders (ACIP [Kroger 2023]).

Medication Guide and/or Vaccine Information Statement (VIS)

In the United States, the appropriate CDC-approved Vaccine Information Statement (VIS) must be provided to the patient/caregiver before administering each dose of this vaccine; the VIS edition date and date it was provided to the patient/caregiver should be recorded as required by US law. VIS is available at https://www.cdc.gov/vaccines/hcp/vis/vis-statements/pcv.html.

Use: Labeled Indications

Pneumococcal disease prevention: Active immunization for the prevention of invasive disease caused by Streptococcus pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 22F, 23F and 33F in patients ≥6 weeks of age.

Advisory Committee on Immunization Practices recommendations:

The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination in the following persons (CDC/ACIP [Kobayashi 2023]):

  • Adults 19 to 64 years of age with any of the following underlying medical conditions or risk factors: Alcohol use disorder, chronic heart disease (including heart failure, cardiomyopathies), chronic liver disease, chronic lung disease (including chronic obstructive pulmonary disease, emphysema, asthma), cigarette smoking, diabetes mellitus, cochlear implant, cerebrospinal fluid leak, immunocompromising conditions (eg, asplenia [congenital or acquired], chronic renal failure, congenital or acquired immunodeficiency [including B- or T-cell deficiency, complement deficiencies and phagocytic disorders; excluding chronic granulomatous disease], malignancy, HIV infection, Hodgkin disease, iatrogenic immunosuppression [including long-term systemic corticosteroid treatment, radiation therapy], leukemia, lymphoma, multiple myeloma, nephrotic syndrome, sickle cell disease or other hemoglobinopathies, solid organ transplant)

  • Adults ≥65 years of age

Medication Safety Issues
Sound-alike/look-alike issues:

PCV15 (pneumococcal 15-valent conjugate vaccine) may be confused with PCV13 (pneumococcal 13-valent conjugate vaccine), PCV20 (pneumococcal 20-valent conjugate vaccine), and PPSV23 (pneumococcal 23-valent polysaccharide vaccine).

Pneumococcal 15-Valent Conjugate Vaccine (Vaxneuvance, PCV15) may be confused with Pneumococcal 13-Valent Conjugate Vaccine (Prevnar 13), Pneumococcal 20-Valent Conjugate Vaccine (Prevnar 20, PCV20), and Pneumococcal 23-Valent Polysaccharide Vaccine (Pneumovax 23).

PCV (pneumococcal conjugate vaccine) may be confused with MCV (meningococcal ACYW conjugate vaccine, MCV4 is the correct abbreviation).

PCV (pneumococcal conjugate vaccine) may be confused with PPD (purified protein derivative tuberculin test).

Metabolism/Transport Effects

None known.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Acetaminophen: May diminish the therapeutic effect of Vaccines. Management: Consider avoiding routine prophylactic use of acetaminophen before or during vaccine administration when possible. Acetaminophen is still recommended to treat fevers and/or pain that occurs after vaccination. Risk D: Consider therapy modification

Anti-CD20 B-Cell Depleting Therapies: May diminish the therapeutic effect of Vaccines (Inactivated/Non-Replicating). Management: Give inactivated vaccines at least 2 weeks prior to initiation or 6 months after anti-CD20 B-cell depleting therapies. If vaccinated prior to B cell recovery, consider assessing immune response to vaccination. Risk D: Consider therapy modification

Cladribine: May diminish the therapeutic effect of Vaccines (Inactivated/Non-Replicating). Management: Give inactivated vaccines at least 2 weeks prior to initiation of cladribine when possible. Patients vaccinated less than 14 days before initiating or during cladribine should be revaccinated at least 3 months after therapy is complete. Risk D: Consider therapy modification

Corticosteroids (Systemic): May diminish the therapeutic effect of Pneumococcal Vaccines. Risk C: Monitor therapy

Elivaldogene Autotemcel: May enhance the adverse/toxic effect of Vaccines. Specifically, there may be a greater risk for contracting an infection from any live vaccine. Elivaldogene Autotemcel may diminish the therapeutic effect of Vaccines. Management: Administration of vaccines is not recommended in the 6 weeks before myeloablative conditioning, and until hematologic recovery after elivaldogene autotemcel treatment. Risk X: Avoid combination

Fingolimod: May diminish the therapeutic effect of Vaccines (Inactivated/Non-Replicating). Management: Vaccine efficacy may be reduced. Complete all age-appropriate vaccinations at least 2 weeks prior to starting fingolimod. If vaccinated during fingolimod therapy, revaccinate 2 to 3 months after fingolimod discontinuation. Risk D: Consider therapy modification

Immunosuppressants (Cytotoxic Chemotherapy): May diminish the therapeutic effect of Pneumococcal Vaccines. Risk C: Monitor therapy

Immunosuppressants (Miscellaneous Oncologic Agents): May diminish the therapeutic effect of Pneumococcal Vaccines. Risk C: Monitor therapy

Immunosuppressants (Therapeutic Immunosuppressant Agents): May diminish the therapeutic effect of Pneumococcal Vaccines. Risk C: Monitor therapy

Methotrexate: May diminish the therapeutic effect of Pneumococcal Vaccines. Risk C: Monitor therapy

Propacetamol: May diminish the therapeutic effect of Vaccines. Management: Consider avoiding routine prophylactic use of propacetamol before or during vaccine administration when possible. Propacetamol is still recommended to treat fevers and/or pain that occurs after vaccination. Risk D: Consider therapy modification

Siponimod: May diminish the therapeutic effect of Vaccines (Inactivated/Non-Replicating). Management: Avoid administration of vaccines (inactivated) during treatment with siponimod and for 1 month after discontinuation due to potential decreased vaccine efficacy. Risk D: Consider therapy modification

Teplizumab: May diminish the therapeutic effect of Pneumococcal Vaccines. Management: Vaccination with inactivated vaccines is not recommended in the 2 weeks prior to teplizumab therapy, during therapy, or for 6 weeks after completion of therapy. See full mono for recommendations for number, order, and timing of vaccines. Risk D: Consider therapy modification

Teplizumab: May diminish the therapeutic effect of Vaccines (Inactivated/Non-Replicating). Management: Vaccination with inactivated or non-replicating vaccines is not recommended in the 2 weeks prior to teplizumab therapy, during treatment, or for 6 weeks following completion of therapy. Risk D: Consider therapy modification

Pregnancy Considerations

Antibodies generated following PCV vaccination of pregnant patients can be detected in cord blood (CDC/ACIP [Kobayashi 2023]; Weinberg 2021).

Nonlive bacterial vaccines have not been shown to cause increased risks to the fetus (ACIP [Kroger 2023]). Although specific recommendations for vaccination of pregnant patients is not available (CDC/ACIP [Kobayashi 2023]), pneumococcal vaccines may be administered during pregnancy in persons at increased risk of severe disease due to underlying medical conditions (ACOG 2018; ACOG 2022).

Breastfeeding Considerations

It is not known if the components of this vaccine are present in breast milk.

According to the manufacturer, the decision to breastfeed following immunization should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and the benefits of vaccination to the mother. Nonlive vaccines have not been shown to affect the safety of the breastfed infant or mother. Breastfeeding infants should be vaccinated according to the recommended schedules (ACIP [Kroger 2023]).

Monitoring Parameters

Monitor for hypersensitivity and syncope for 15 minutes following administration (ACIP [Kroger 2023]). If seizure-like activity associated with syncope occurs, maintain patient in supine or Trendelenburg position to reestablish adequate cerebral perfusion.

Mechanism of Action

Promotes active immunization against invasive disease caused by S. pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 22F, 23F, and 33F, each of which are individually conjugated to CRM197 protein.

Pharmacokinetics (Adult Data Unless Noted)

Onset: Immune response was elicited by 30 days postvaccination.

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Vaxneuvance;
  • (AT) Austria: Vaxneuvance;
  • (BE) Belgium: Vaxneuvance;
  • (CZ) Czech Republic: Vaxneuvance;
  • (ES) Spain: Vaxneuvance;
  • (FI) Finland: Vaxneuvance;
  • (GR) Greece: Vaxneuvance;
  • (IE) Ireland: Vaxneuvance;
  • (IT) Italy: Vaxneuvance;
  • (LU) Luxembourg: Vaxneuvance;
  • (LV) Latvia: Vaxneuvance;
  • (NL) Netherlands: Vaxneuvance;
  • (NO) Norway: Vaxneuvance;
  • (PT) Portugal: Vaxneuvance;
  • (QA) Qatar: Vaxneuvance;
  • (SE) Sweden: Vaxneuvance;
  • (TW) Taiwan: Vaxneuvance;
  • (ZA) South Africa: Vaxneuvance
  1. American College of Obstetricians and Gynecologists (ACOG). Committee Opinion no. 741: maternal immunization. Obstet Gynecol. 2018;131(6):e214-e217. doi:10.1097/AOG.0000000000002662 [PubMed 29794683]
  2. American College of Obstetricians and Gynecologists (ACOG). Maternal immunization practice advisory. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2022/10/maternal-immunization. Updated October 2022. Accessed December 13, 2022.
  3. Centers for Disease Control and Prevention (CDC). Pneumococcal Vaccination. https://www.cdc.gov/pneumococcal/vaccination.html. Updated January 20, 2023. Accessed June 8, 2023.
  4. Cross GB, Moghaddas J, Buttery J, Ayoub S, Korman TM. Don't aim too high: avoiding shoulder injury related to vaccine administration. Aust Fam Physician. 2016;45(5):303-306. [PubMed 27166466]
  5. Farrar JL, Gierke R, Andrejko, et al. ACIP updates: recommendations for use of 20-valent pneumococcal conjugate vaccine in children - United States, 2023. MMWR Morb Mortal Wkly Rep. 2023;72(39):1072. doi:10.15585/mmwr.mm7239a5 [PubMed 37768876]
  6. Foster SL, Davis MV. Vaccine administration: preventing serious shoulder injuries. J Am Pharm Assoc (2003). 2013;53(1):102-103. doi:10.1331/JAPhA.2013.13503 [PubMed 23636163]
  7. Kobayashi M, Farrar JL, Gierke R, et al. Use of 15-valent pneumococcal conjugate vaccine among U.S. children: updated recommendations of the Advisory Committee on Immunization Practices - United States, 2022. MMWR Morb Mortal Wkly Rep. 2022;71(37):1174-1181. doi:10.15585/mmwr.mm7137a3 [PubMed 36107786]
  8. Kobayashi M, Pilishvil T, Gierke R, et al. Pneumococcal vaccine for adults aged ≥ 19 years: recommendations of the Advisory Committee on Immunization Practices - United States, 2023. MMWR Morb Mortal Wkly Rep. 2023;72(3):1-39. doi:10.15585/mmwr.rr7203a1 [PubMed 37669242]
  9. Kroger A, Bahta L, Long S, Sanchez P. General best practice guidelines for immunization: best practices guidance of the Advisory Committee on Immunization Practices (ACIP). https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html. Accessed June 8, 2023.
  10. Prymula R, Siegrist CA, Chlibek R, et al. Effect of prophylactic paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: two open-label, randomised controlled trials. Lancet. 2009;374(9698):1339-1350. doi:10.1016/S0140-6736(09)61208-3 [PubMed 19837254]
  11. Rubin LG, Levin MJ, Ljungman P, et al; Infectious Diseases Society of America. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis. 2014;58(3):309-318. doi:10.1093/cid/cit816 [PubMed 24421306]
  12. Vaxneuvance (pneumococcal conjugate vaccine [15-Valent]) [prescribing information]. Whitehouse Station, NJ: Merck Sharp & Dohme Corp; received May 2023.
  13. Vaxneuvance (pneumococcal conjugate vaccine [15-Valent]) [product monograph]. Kirkland, Quebec, Canada: Merck Canada Inc; July 2023.
  14. Weinberg A, Muresan P, Laimon L, et al; NICHD P1091 study team. Safety, immunogenicity, and transplacental antibody transport of conjugated and polysaccharide pneumococcal vaccines administered to pregnant women with HIV: a multicentre randomised controlled trial. Lancet HIV. 2021;8(7):e408-e419. doi:10.1016/S2352-3018(20)30339-8 [PubMed 33915104]
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