Pneumococcal Vaccines:  Prevnar (7 valent pneumococcal vaccine, PCV7) and Pneumovax (23 valent pneumococcal vaccine, 23PS)

Prevnar (13 valent pneumococcal vaccine, PCV13) and Pneumovax (23 valent pneumococcal vaccine, 23PS).  Prevnar and Pneumovax are vaccines that are given to prevent diseases caused by a bacteria named streptococcus pneumonia. This germ causes several very serious diseases such as bacteremia (bacterial infection of the blood), meningitis (infection of the brain and spinal cord), and pneumonia. Less serious diseases such as sinus infections and ear infections (otitis media) are also caused by this bacteria. In recent years, this bacteria has developed significant resistance problems to many antibiotics which is very problematic. Because of the seriousness of the diseases mentioned above and the development of antibiotic resistance of this bacteria, this trend is concerning. To help combat this growing problem of resistance and to prevent pneumococcal disease, particularly in small children, Prevnar has been developed.

For years a vaccine named Pneumovax, which is active against 23 serotypes of pneumococci has been available. Because children younger than two years usually do not respond to this vaccine, it is ineffective if given before this age. Because the bulk of serious pneumococcal disease happens before the end of the second year of life, it was important to close this gap.  Therefore in 2000 Prevnar (PCV7) was licensed for use in the United States.  Since then, six more strains of pneumococcus vaccine have been added to make PCV13. Thus, Prevnar now protects against the 13 most common strains of Pneumococcus that cause invasive disease in humans. The vaccine is more immunogenic than Pneumovax because it is combined with a protein carrier that the body easily identifies as foreign. Prevnar is given to children under the age of two and Pneumovax is the vaccine given to older individuals. We now recommend that all infants be given four doses of the Prevnar (PCV13) vaccine in the first year of life. The Pneumovax vaccine (23PS) protects against several different types of the pneumococcus bacteria and it is recommended that to be given to people over age 65 and patients over age two who are at high risk for pneumococcal disease (immune defects, diabetics, heart disease, cochlear implants, renal failure, organ transplants, asplenia, recurrent pneumonia). See our immunization schedule in the back of this handbook for more details.

The AAP recommends the routine use of Prevnar (PCV13) for all children 23 months and younger. Children with severe, recurrent or complicated otitis media (ear infections) also may experience a modest benefit from the Prevnar vaccine. Studies have shown that in children who received Prevnar Vaccination, the incidence of clinically diagnosed otitis media (ear infections) was modestly reduced by 7% to 8% and up to 23% for very frequent otitis media.  This is defined as 5 episodes of ear infections in 6 months or 6 episodes in 12 months. The frequency of tympanostomy tubes was reduced by about 20% in children who received the Prevnar vaccine.

The incidence of adverse reactions (side effects) was low and limited to local reactions of erythema (redness) or swelling (less than an inch) at the site of injection in 33% to 43% of children. The incidence of fever was 26% when given with other routine vaccines. Rates of fever greater than 104 degrees Fahrenheit did not exceed 5%. Other reactions included drowsiness (27% to 49%), fussiness (37% to 39%) and decreased appetite (12% to18%) when given along with other childhood vaccines. Serious adverse reactions have not been a problem.

View the CDC Prevnar vaccine sheet here:  vis-pcv.pdf

View the CDC Pneumovax vaccine sheet here:  vis-ppv.pdf