Pneumococcal 21-valent conjugate vaccine (Capvaxive) will be another option for pneumococcal vaccination in adults 18 years and up.
PCV21 is a conjugate vaccine...like PCV15 (Vaxneuvance) and PCV20 (Prevnar 20).
But it isn’t just “PCV20 plus 1”...it covers 10 of the same serotypes as PCV20...plus 11 others. And PCV21 protects against 8 serotypes not in any other pneumococcal vaccine.
Data show that PCV21 targets serotypes that cause 77% to 85% of invasive pneumococcal disease...versus 56% to 65% with PCV20.
But unlike PCV20 or PCV15, PCV21 doesn’t cover serotype 4 or 9V...which are causing more cases of invasive pneumococcal disease in younger adults, particularly serotype 4 in Northern Canada.
Rely on PCV20 or PCV21 as your workhorse product for adults.
Keep in mind that PCV21 is currently only approved for ages 18 years and up. But PCV20 can be used to immunize EITHER adults or children.
Give PCV15 only when PCV20 and PCV21 aren’t available...it covers fewer serotypes and requires coming back for pneumococcal polysaccharide vaccine, PPSV23 (Pneumovax 23), usually a year later.
Use the table below to keep it all straight.
In general, focus on getting eligible adults vaccinated with PCV20 or PCV21...rather than worrying too much about which of these they get.
But weigh nuances...and consider your population, location, etc.
For example, go with PCV21 for better overall serotype coverage.
But lean toward PCV20 if invasive pneumococcal disease due to serotype 4 or 9V is a concern...such as for younger adults living in Northern Canada or those experiencing homelessness.
And consult with a transplant specialist if needed...adults who receive a hematopoietic stem cell transplant should get BOTH PCV20 and PCV21 for broader coverage.
Point out that PCV21 costs about $140/dose...PCV20 about $120/dose.
Dive into our updated chart, Comparison of Pneumococcal Vaccines, for more on serotypes, dosing, and cost.
- Health Canada. Summary of NACI statement of November 15, 2024: Recommendations on the use of pneumococcal vaccines in adults, including PNEU-C-21. https://www.canada.ca/en/public-health/services/publications/vaccines-immunization/national-advisory-committee-immunization-summary-recommendations-use-pneumococcal-vaccines-adults-pneu-c-21.html (Accessed January 10, 2025).
- Health Canada. Pneumococcal vaccines: Canadian Immunization Guide. November 15 2024. https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-16-pneumococcal-vaccine.html (Accessed January 10, 2025).