2022 Pneumococcal Vaccine Update
In 2021, the FDA approved two new pneumococcal conjugate vaccines (PCV), PCV15 and PCV20, for use in patients 18 years of age and older.
For patients with chronic conditions such as asthma or COPD (for other chronic conditions), the Advisory Committee on Immunization Practices (ACIP) now recommends either one dose of PCV20 alone OR one dose of PCV15 followed by one dose of PPSV23 one or more years later in patients 19-64 years of age who have not previously received a PCV vaccine.
In patients 65 years of age and older who have not previously received a PCV vaccine, ACIP recommends one dose of PCV20 alone OR one dose of PCV15 followed by one dose of PPSV23 one or more years later.
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In clinical trials, both new vaccines had comparable safety and efficacy compared to PCV13 while being cost-effective in both age ranges.
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Adults 18-64 years with certain underlying conditions/risk factors
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Adults 65 years and older not previously vaccinated or vaccine history is unknown
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Adults with previous PPSV23 only
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Adults with previous PCV13**
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PCV15
(VaxneuvanceTM)
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1 dose followed by PPSV23 ≥1 year later
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1 dose followed by PPSV23 ≥1 year later
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1 dose ≥1 year after PPSV23 dose*
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Hasn’t been evaluated
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OR
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OR
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OR
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OR
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PCV20
(Prevnar 20TM)
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1 dose only
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1 dose only
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1 dose ≥1 year after PPSV23 dose
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May receive one dose***
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*Current recommendations state in those who previously received PPSV23 and then PCV15, another dose of PPSV23 ≥1 year later is not necessary.
**The health benefits of receiving PCV15 or PCV20 after receiving PCV13 alone or with PPSV23 has not been studied. It is currently recommended to complete the previously recommended PPSV23 series.
***In patients who have received one dose of PCV13 but not completed the series with PPSV23, a single PCV20 dose can be administered if PPSV23 is not available.
Pharmacists:
Review the immunization schedules for patients at the CDC website so you can provide the most up-to-date vaccines for your patients.
Tessa Hultgren, PharmD Candidate reviewed by Rachael Zins, PharmD, AE-C
Talking to Patients About Cardiovascular Risk
Example Case
Bill C. is 55 years old and has always considered himself in good health. He is physically active, a non-smoker, and makes healthy food choices. He presents to you with new prescriptions for a blood pressure medication and a statin. He wants to talk to you before starting the medications because he was so surprised with his diagnoses that he recalls little about his conversation with the provider. How will you offer to guide Bill in his decision-making process?
The Problem
The treatments for hypertension and hyperlipidemia are designed to reduce the risk of having a cardiovascular event.
The prescribing of medications should be patient centered, guideline directed, and based on shared decision-making principles. The patient may not remember, even if the information was offered, all the key points in the prescriber consultation.
The ACTION Survey was designed to study the conversations between prescribers and patients who were prescribed statin therapy. The survey demonstrated that significant numbers of patients were not told or did not remember being told, about side effects, potential drug interactions, that there were different statins and different potencies, and the benefits of therapy. The patient’s understanding the risk of having a first or second cardiovascular event is central to making good self-care and medication taking decisions.
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“When risk isn’t communicated well-or at all-it can cause undue harm. However, if it is presented in a way that is meaningful to and actionable for patients, it can serve as a key motivator to initiate and adhere to treatment plans.”
- American College of Cardiology
Being part of the solution
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Pharmacists can educate patients about the reasons for taking medications.
- Initiating new prescriptions or continuing to take medications for chronic health conditions.
- Patients are often unable to estimate their personal risk for cardiovascular disease (CVD).
- What do we say to that person who refuses to fill a prescription that we know is effective in reducing cardiovascular events?
Pharmacists: The 3-minute extra mile
Points to consider when speaking with patients:
- Understand the patient’s priorities.
- Use non-medical terms (heart attack and stroke vs cardiovascular event)
- Use event frequencies rather than percentages (Read more)
- Clarify that hypertension and dyslipidemia are asymptomatic in most people
James Bennett BsPharm, CDCES, BCGP
Bozeman MT
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