Pneumococcal polysaccharide vaccine, sold under the brand name Pneumovax 23, is a pneumococcal vaccine that is used for the prevention of pneumococcal disease caused by the 23 serotypes of Streptococcus pneumoniae contained in the vaccine as capsular polysaccharides.

First used in 1945, the tetravalent vaccine was not widely distributed, since its deployment coincided with the discovery of penicillin. In the 1970s, Robert Austrian championed the manufacture and distribution of a 14-valent pneumococcal polysaccharide vaccine. This evolved in 1983 to a 23-valent formulation (PPSV23). A significant breakthrough affecting the burden of pneumococcal disease was the licensing of a protein conjugate heptavalent vaccine (PCV7) beginning in February 2000.

Medical uses

In the United States, pneumococcal vaccine, polyvalent is indicated for active immunization for the prevention of pneumococcal disease caused by the 23 serotypes contained in the vaccine (1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F, and 33F). The World Health Organization (WHO) recommendations are similar. The WHO does not recommend use of pneumococcal polysaccharide vaccine in routine childhood immunization programs. The recommendations in the UK are similar, but include people with occupational hazards.

Pneumococcal vaccine may be beneficial to control exacerbations of chronic obstructive pulmonary disease (COPD).

The pneumococcal polysaccharide vaccine is important for those with HIV/AIDS. In Canadian patients infected with HIV, the vaccine has been reported to decrease the incidence of invasive pneumococcal disease from 768 per 100,000 person–years to 244 per 100,000 patient–years.

Adverse events

The most common adverse reactions (reported in more than 10% of subjects vaccinated with pneumococcal polysaccharide vaccine in clinical trials) were: pain, soreness or tenderness at the site of injection (60.0%), injection-site swelling or temporary thickening or hardening of the skin (20.3%), headache (17.6%), injection-site redness (16.4%), weakness and fatigue (13.2%), and muscle pain (11.9%). As of 2025, a 15-valent, and later 20-valent (PCV20: Prevnar 20) successors to the Prevnar 13 have been introduced, in addition to the introduction of an 21-valent vaccine (PCV21: Capvaxive) not directly derived from the Prevnar series.. The PCV20 supersedes the PCV15, PCV13, and PCV7, but the PCV21 contains 11 serotypes not covered by the PCV20, and the distinct mechanism of the PPSV23 means it may be indicated in different circumstances than the conjugate vaccines. The PPSV23 additionally contains 2 serotypes not contained in the PCV20 but contained within the PCV21, and 2 serotypes contained within neither; the remaining 19 serotypes overlap the PCV20, notwithstanding the PCV21.

;Special risk-groups:Children at special risk (e.g., sickle cell disease and those without a functioning spleen) require additional protection using the PCV13, with the more extensive PPSV-23 given after the second year of life or two months after the PCV13 dose:

{| class="wikitable"

|+Vaccination schedule for children at special risk in the UK

|-

| align="center" | Age || align="center" |2–6 months || align="center" |7–11 months || align="center" |12–23 months

|-

| rowspan=2 align="center" | PCV13 || align="center"| 3 × monthly dose || align="center" | 2 × monthly dose || rowspan="2" align="center" | 2 doses, 2 months apart

|-

| colspan=2 align="center"| Further dose in second year of life

|-

| align="center" | PPSV-23 || colspan=3 align="center" | Single dose after second year of life, 2 months after PCV13

|}

References

Further reading

  • Pneumococcal Disease World Health Organization (WHO)