1. Centers for Disease Control and Prevention (CDC). Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among adults aged ≥65 years: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2014;63(37):822–825.
2. Centers for Disease Control and Prevention (CDC). Intervals between PCV13 and PPSV23 vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2015;64(34):944–947. (Erratum Notice: CDC. MMWR Morb Mortal Wkly Rep. 2015;64(42):1204.)
3. Centers for Disease Control and Prevention (CDC). Storage and handling. In: Hamborsky J, Kroger A, Wolfe S, eds. Epidemiology and Prevention of Vaccine-Preventable Diseases. 13th ed. Washington, DC: Public Health Foundation; 2015:63–78.
4. Prevnar 13 [package insert]. Philadelphia, PA: Wyeth Pharmaceuticals Inc; 2017.
5. Data available on request from Merck, Professional Services-DAP, WP1-27, PO Box 4, West Point, PA 19486-0004. Please specify information package VACC-1222858-0000.
6. Centers for Disease Control and Prevention (CDC). Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine for adults with immunocompromising conditions: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2012;61(40):816–819.
7. Shea KM, Edelsberg J, Weycker D, et al. Rates of pneumococcal disease in adults with chronic medical conditions. Open Forum Infect Dis. 2014;1(1):1–9.
8. American Diabetes Association. Standards of medical care in diabetes—2017. Diabetes Care. 2017;40(suppl 1):S25–S32.
9. Handelsman Y, Bloomgarden ZT, Grunberger G, et al. American Association of Clinical Endocrinologists and American College of Endocrinology—clinical practice guidelines for developing a diabetes mellitus comprehensive care plan—2015. Endocr Pract. 2015;21(suppl 1):1–87.
10. Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non–st-elevation acute coronary syndromes. J Am Coll Cardiol. 2014;64(24):e139–e228.
11. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Updated 2017. http://goldcopd.org/gold-2017-global-strategy-diagnosis-management-prevention-copd/. Accessed August 9, 2017.
12. Centers for Disease Control and Prevention (CDC). Noninfluenza vaccination coverage among adults - United States, 2011. MMWR Morb Mortal Wkly Rep. 2013;62(4):66–72.
13. Centers for Disease Control and Prevention (CDC). Vaccination coverage among adults in the United States, NHIS, 2015. cdc.gov/vaccines/imz-managers/coverage/adultvaxview/coverage-estimates/2015.html. Accessed August 18, 2017.
14. US Department of Health and Human Services. Healthy People 2020: Immunization and Infectious Diseases. healthypeople.gov/2020/topics-objectives/topic/immunization-and-infectious-diseases/objectives. Accessed August 18, 2017.
15. Butler JC, Breiman RF, Campbell JF, et al. Pneumococcal polysaccharide vaccine efficacy: an evaluation of current recommendations. JAMA. 1993;270(15):1826–1831.
16. Centers for Disease Control and Prevention (CDC). Pneumococcal disease: surveillance and reporting. cdc.gov/pneumococcal/surveillance.html. Updated June 21, 2016. Accessed August 24, 2017.
17. Pilishvili T, Ahmed S, Xing W, et al. Impact of 13-valent pneumococcal conjugate vaccine use in the US on invasive pneumococcal disease (IPD) among adults with chronic conditions. Poster #0638. Presented at: 10th International Symposium on Pneumococci and Pneumococcal Diseases; June 26–30, 2016; Glasgow, Scotland.
18. Centers for Medicare & Medicaid Services. Modifications to Medicare Part B coverage of pneumococcal vaccinations. http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9051.pdf. Accessed August 24, 2017.
19. National Committee for Quality Assurance (NCQA). HEDIS® 2018 Measures. http://www.ncqa.org/hedis-quality-measurement/hedis-measures/hedis-2018. Accessed November 7, 2017.
20. Data available on request from Merck, Professional Services-DAP, WP1-27, PO Box 4, West Point, PA 19486-0004. Please specify information package VACC-1163180-0002.
21. Data available on request from Merck, Professional Services-DAP, WP1-27, PO Box 4, West Point, PA 19486-0004. Please specify information package VACC-1163180-0012.
22. Data available on request from Merck, Professional Services-DAP, WP1-27, PO Box 4, West Point, PA 19486-0004. Please specify information package VACC-1163180-0005.

Indication

PNEUMOVAX®23 (Pneumococcal Vaccine Polyvalent) is a vaccine 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).

PNEUMOVAX 23 is approved for use in persons 50 years of age or older and persons aged ≥2 years who are at increased risk for pneumococcal disease.

PNEUMOVAX 23 will not prevent disease caused by capsular types of pneumococcus other than those contained in the vaccine.

Select Safety Information for PNEUMOVAX®23 (Pneumococcal Vaccine Polyvalent)

Do not administer PNEUMOVAX 23 to individuals with a history of a hypersensitivity reaction to any component of the vaccine.

Defer vaccination with PNEUMOVAX 23 in persons with moderate or severe acute illness.

Use caution and appropriate care in administering PNEUMOVAX 23 to individuals with severely compromised cardiovascular and/or pulmonary function in whom a systemic reaction would pose a significant risk.

PNEUMOVAX 23 should be given to a pregnant woman only if clearly needed.

Caution should be exercised when PNEUMOVAX 23 is administered to a nursing woman.

Since elderly individuals may not tolerate medical interventions as well as younger individuals, a higher frequency and/or a greater severity of reactions in some older individuals cannot be ruled out.

Persons who are immunocompromised, including persons receiving immunosuppressive therapy, may have a diminished immune response to PNEUMOVAX 23.

PNEUMOVAX 23 may not be effective in preventing pneumococcal meningitis in patients who have chronic cerebrospinal fluid (CSF) leakage resulting from congenital lesions, skull fractures, or neurosurgical procedures.

The most common adverse reactions, reported in >10% of subjects vaccinated with PNEUMOVAX 23 in clinical trials, were: injection-site pain/soreness/tenderness, injection-site swelling/induration, headache, injection-site erythema, asthenia and fatigue, and myalgia.

For subjects aged 65 years or older in a clinical study, systemic adverse reactions which were determined by the investigator to be vaccine-related were higher following revaccination than following initial vaccination.

Vaccination with PNEUMOVAX 23 may not offer 100% protection from pneumococcal infection.

Before administering PNEUMOVAX®23 (Pneumococcal Vaccine Polyvalent), please read the accompanying Prescribing Information. The Patient Information also is available.

Pneumococcal Vaccine Serotypes

With their recommended dose of PNEUMOVAX 23, patients will be vaccinated against additional pneumococcal serotypes not contained in PCV1316

  • Serotypes Contained in PNEUMOVAX 23 (PPSV23) and PCV13

    Serotypes Contained in PNEUMOVAX 23 (PPSV23) and PCV13

    Different serotypes can cause pneumococcal disease

    PNEUMOVAX 23 is the only pneumococcal vaccine indicated to prevent disease caused by 23 serotypes4

    Serotypes Contained in PPSV23 and PCV13 Serotypes Contained in PPSV23 and PCV13

    PCV13=13-valent pneumococcal conjugate vaccine.

    PNEUMOVAX 23 (PPSV23) will not prevent disease caused by capsular types of pneumococcus other than those contained in the vaccine.

  • Vaccine Serotypes and IPD Cases in Adult Patients

    Vaccine Serotypes and IPD Cases in Adult Patients

    The serotypes contained in PNEUMOVAX 23 accounted for a greater percentage of invasive pneumococcal disease (IPD) cases compared to the percentage of IPD cases caused by serotypes in PCV1316

    Percentage of IPD cases caused by serotypes in each vaccine—United States 201516

    Patients under age 65: ~38% of invasive pneumococcal disease cases were caused by the 11 unique serotypes in PNEUMOVAX®23 (Pneumococcal Vaccine Polyvalent) Patients under age 65: ~38% of invasive pneumococcal disease cases were caused by the 11 unique serotypes in PNEUMOVAX®23 (Pneumococcal Vaccine Polyvalent)
    Patients aged 65 and older: ~35% of invasive pneumococcal disease cases were caused by the 11 unique serotypes in PNEUMOVAX®23 (Pneumococcal Vaccine Polyvalent) Patients aged 65 and older: ~35% of invasive pneumococcal disease cases were caused by the 11 unique serotypes in PNEUMOVAX®23 (Pneumococcal Vaccine Polyvalent)

    % of IPD cases

    % IPD cases due to serotypes in PNEUMOVAX 23 (PPSV23)

    % IPD cases due to serotypes in PCV13

    Data derived from the Active Bacterial Core
    Surveillance Data, unpublished.

    The figure depicts CDC epidemiologic data and does not reflect the efficacy of the respective vaccines.

    Data derived from the Active Bacterial Core Surveillance Data, unpublished.

    According to the CDC in 2013–2014

    In adult patients aged 19–64 years with certain chronic conditions, ~40% of IPD cases were caused by the 11 unique serotypes of PNEUMOVAX 2317

    • 43% in patients with diabetes mellitusa
    • 43% in patients with chronic lung disease (COPD)b
    • 40% in patients with chronic heart diseasec
  • Study Design: Burden of IPD by serotype group in adults aged 19–64 years with certain chronic conditions in 2013–2014. The data were compiled by the CDC from 2 sources: The Active Bacterial Core Surveillance ABCs and the National Health Interview Survey.17
    aIn patients with diabetes mellitus, 43% of IPD burden was caused by PNEUMOVAX 23 unique serotypes, 22% by PCV13 serotypes, and 35% caused by non-vaccine serotypes.17
    bIn patients with chronic lung disease, 43% of IPD burden was caused by PNEUMOVAX 23 unique serotypes, 29% by PCV13 serotypes, and 29% caused by non-vaccine serotypes.17
    cIn patients with chronic heart disease, 40% of IPD burden was caused by PNEUMOVAX 23 unique serotypes, 20% by PCV13 serotypes, and 40% caused by non-vaccine serotypes.17

    COPD=chronic obstructive pulmonary disease.

Indication

PNEUMOVAX®23 (Pneumococcal Vaccine Polyvalent) is a vaccine 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).

PNEUMOVAX 23 is approved for use in persons 50 years of age or older and persons aged ≥2 years who are at increased risk for pneumococcal disease.

PNEUMOVAX 23 will not prevent disease caused by capsular types of pneumococcus other than those contained in the vaccine.

Select Safety Information for PNEUMOVAX®23 (Pneumococcal Vaccine Polyvalent)

Do not administer PNEUMOVAX 23 to individuals with a history of a hypersensitivity reaction to any component of the vaccine.

Defer vaccination with PNEUMOVAX 23 in persons with moderate or severe acute illness.

Use caution and appropriate care in administering PNEUMOVAX 23 to individuals with severely compromised cardiovascular and/or pulmonary function in whom a systemic reaction would pose a significant risk.

PNEUMOVAX 23 should be given to a pregnant woman only if clearly needed.

Caution should be exercised when PNEUMOVAX 23 is administered to a nursing woman.

Since elderly individuals may not tolerate medical interventions as well as younger individuals, a higher frequency and/or a greater severity of reactions in some older individuals cannot be ruled out.

Persons who are immunocompromised, including persons receiving immunosuppressive therapy, may have a diminished immune response to PNEUMOVAX 23.

PNEUMOVAX 23 may not be effective in preventing pneumococcal meningitis in patients who have chronic cerebrospinal fluid (CSF) leakage resulting from congenital lesions, skull fractures, or neurosurgical procedures.

The most common adverse reactions, reported in >10% of subjects vaccinated with PNEUMOVAX 23 in clinical trials, were: injection-site pain/soreness/tenderness, injection-site swelling/induration, headache, injection-site erythema, asthenia and fatigue, and myalgia.

For subjects aged 65 years or older in a clinical study, systemic adverse reactions which were determined by the investigator to be vaccine-related were higher following revaccination than following initial vaccination.

Vaccination with PNEUMOVAX 23 may not offer 100% protection from pneumococcal infection.

Before administering PNEUMOVAX®23 (Pneumococcal Vaccine Polyvalent), please read the accompanying Prescribing Information. The Patient Information also is available.

CDC=Centers for Disease Control and Prevention.
VACC-1101056-0024 05/18