Question About Newer Pneumococcal Vaccines

Q: In May of 2014, I was in the hospital for inguinal hernia repair and was offered the Pneumovax® 23, which I had been wanting for some time but none of my doctors would approve it. I did not ask for the Pneumovax® 23 at this time; it was offered to me and I accepted. I recently requested the Prevnar® 13, but my doctor denied it because I am not yet 65 (I understand the usual guidelines). I do have chronic health issues, which I believe would be an exception to the guidelines. What I don’t understand is, why give one without the other? Why be protected by 23 but not the additional 13?

The Pneumovax® 23 and Prevnar® 13 vaccines have 12 serotypes or variations, in common, which protect you against over the same 12 variations of the illness. Prevnar® 13 covers one more serotype, and Pneumovax® 23 covers 11 more serotypes. If you get immunized with Prevnar® 13 you are only getting 1 new serotype compared to the older vaccine.

What’s the main difference between the two vaccines? Although you don’t get as broad of coverage because of only 13 serotypes compared to 23 serotypes, the immune response from the Prevnar® 13 has been shown to be is a little bit better than with the Pneumovax® 23.

The Prevnar® 13 vaccine is recommended for all adults 65 years and older, but for younger adults ONLY IF you have a medical condition that causes you to be immunocompromised, such as removal of your spleen, HIV infection, organ transplant, chronic kidney failure, or long term use of immunosuppressive drugs like cortisone or Humira®. If you have one of those conditions, the Prevnar® 13 would give you a little better protection.

Since you received the Pneumovax® 23 before age 65, you should get another dose of it at or after age 65. However, for the best protection you should wait at least 11months or 1 year before getting the other pneumococcal vaccine. This means that if you get the Prevnar® 13 at age 65, you should wait a year before getting the Pneumovax® 23.

According to the Centers for Disease Control and Prevention (CDC), the maximum number of pneumococcal vaccines needed three: up to 2 doses of the older Pneumovax® 23 vaccine and only 1 dose of the Prevnar® 13. Most pharmacies carry both vaccines and can administer them to you. If your doctor declines to give you Prevnar®13, you have the option of going to your local pharmacy and having them give it to you.

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