Which pneumococcal vaccine is best for elderly with COPD?

Question

Hello doctor,

My father is 68 and has COPD, and his pulmonologist mentioned the importance of getting the pneumococcal vaccine. I am confused because I see different vaccine names like PCV13, PCV15, and PPSV23.

How do we know which one he needs and in what sequence?
Also, are there any significant side effects we should expect?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

Types of pneumococcal vaccines are as follows:

Currently, the main pneumococcal vaccines used in adults are:

PCV13 (Prevnar 13) – Conjugate vaccine covering 13 serotypes.
PCV15 (Vaxneuvance) – Conjugate vaccine covering 15 serotypes.
PCV20 (Prevnar 20) – Conjugate vaccine covering 20 serotypes.
PPSV23 (Pneumovax 23) – Polysaccharide vaccine covering 23 serotypes.

Current CDC / GOLD 2024 recommendations (for adults 65 or older or with COPD - chronic obstructive pulmonary disease) are as follows:

Option A (simplest, most used now): Single dose of PCV20 (Prevnar 20). No further pneumococcal vaccine is needed afterward.
Option B (if PCV15 is given instead): Give PCV15 (Vaxneuvance). Then give PPSV23 (Pneumovax 23) at least one year later (can be shortened to eight weeks if high risk, such as severe COPD or immunocompromised).

PCV13 is now rarely used unless the newer vaccines are not available; PCV15 or PCV20 are preferred because they cover more strains.

To decide for your father. Consider the points below:

If he has not received any pneumococcal vaccine yet, the best and simplest choice is one dose of PCV20 (Prevnar 20).
If PCV20 is not available, give PCV15 (Vaxneuvance), then PPSV23 (Pneumovax 23) one year later.
If he previously received PPSV23 or PCV13, the schedule can be adjusted depending on what he has already had.

Common side effects are as follows:

Usually mild and temporary: pain, redness, or swelling at the injection site.
Mild fever or fatigue.
Headache or muscle aches.
Severe allergic reactions are extremely rare.

Vaccination can be done even if he is stable on COPD medications or using inhalers. In COPD patients, pneumococcal pneumonia can lead to exacerbations (flare-ups), hospitalization, and higher mortality. Vaccination significantly reduces these risks.

I hope that this answers your query.

Kindly follow up if you have more doubts.

Thank you.