The COVID-19 pandemic has shown us the importance of scientific breakthroughs and vaccines. Another crucial vaccine was FDA-approved in July 2021: Prevnar 20.
Prevnar 20¹ (Pneumococcal 20-valent Conjugate Vaccine) prevents invasive disease and pneumonia caused by 20 different Streptococcus pneumoniae (pneumococcus) serotypes (bacteria variations).
Preventing pneumococcal diseases such as pneumonia and bacterial meningitis is vital for humanity. The pneumonia mortality rate in people over 70 has hardly decreased since 1990². In 1990, more than 2 million children died from pneumonia.
Thanks to science, we’ve seen an incredible three-fold decrease in child mortality, but it’s still a huge problem.
The Prevnar 20 vaccine gives us some hope.
Prevnar 20 is a single-dose intramuscular (IM) injection for adults aged 18 and over. Wyeth Pharmaceuticals, a subsidiary of Pfizer, manufactures the vaccine.
Let’s learn more about pneumococcal disease and how vaccines give us hope for a future without pneumonia.
Pneumonia is an acute respiratory infection affecting the lungs. Your lungs have small air-filled sacs called alveoli. Pneumonia causes these sacs to fill with pus and fluid. This makes breathing difficult and painful, limiting your oxygen intake.
Pneumonia can be caused by bacteria, viruses, or fungi. Streptococcus pneumoniae (commonly shortened to pneumococcus) is the most common bacterial cause of pneumonia. It also causes an infection called pneumococcal disease.
Pneumococcus can cause other invasive diseases which affect germ-free parts of the body. The blood can be affected, resulting in sepsis, a life-threatening infection.
In 2019, 2.5 million³ people died from pneumonia.
While pneumococcal infections affect everyone, children younger than two and adults over 65 are at higher risk.
Pneumococcus can also cause meningitis. Around 15% of children⁴ with pneumococcal meningitis die, and 25% experience severe complications, including seizures, loss of sight or hearing, and learning or language disabilities.
Every year, hundreds of thousands of children die from pneumonia, a largely preventable disease. 740,180 children⁵ under the age of five died in 2019 due to pneumonia. It’s the leading cause of death for children under five, accounting for 22% of all deaths in children aged one to five.
Children are most likely to die from pneumonia across South Asia and Sub-Saharan Africa. Over half of all deaths from childhood pneumonia were in five countries:
Democratic Republic of Congo
This led to Kevin Watkins and Devi Sridhar calling pneumonia “the ultimate disease of poverty” in a 2018 article in The Lancet⁶.
Pneumonia doesn’t easily spread across borders. The transmission tends to be limited to local communities, so simple healthcare measures can control it as long as they are available. However, there is a strong correlation between a country’s income and its child mortality rate.
These countries often have poor healthcare infrastructure, and people can’t afford treatment, so pneumonia is most common in less economically developed places.
Pneumococcal vaccines can protect us against pneumococcal diseases like pneumonia, reducing the number of deaths from the infection.
The Centers for Disease Control (CDC⁷) recommends pneumococcal vaccinations for children under two and adults over 65. If you or your child are immunocompromised or have a long-term health condition, such as a heart condition, you should be offered the vaccine regardless of age.
There are other circumstances where your doctor will recommend the vaccination. If you’re unsure, ask them if you fit the criteria.
The US Food and Drug Administration (FDA) has approved four pneumococcal vaccines:
Pneumovax 23® is the oldest pneumococcal vaccine available, with the FDA approving it almost 40 years ago in 1983. Prevnar 13® has been FDA-approved since 2011 after studies demonstrated protection against serious pneumococcal infections.
As Vaxneuvance® and Prevnar 20® are new vaccines, there’s no data on how effective they are in the general population. The FDA approved these vaccines due to clinical trial data establishing a similar immune response to Prevnar 13®.
Prevnar 20 is a pneumococcal conjugate vaccine (PCV): Conjugate means “joined” or “connected.”
Polysaccharides are a type of complex sugar, and they cover certain bacteria. Training your immune system to recognize the bacteria must be attuned to the sugary coating. The best way to do this is to attach the sugar to an antigen your body knows well.
In most vaccines, this is diphtheria or tetanus toxoid protein.
As your immune system easily recognizes these proteins, it generates a stronger immune reaction to the polysaccharide.
Prevnar 20 uses 20 different polysaccharides that match 20 serotypes, hence the name PCV20. If the bacteria variation for which you’ve received a vaccine enters your body, your immune system recognizes the polysaccharide and releases antibodies to fight it before it infects you.
The vaccine only uses a certain portion of the bacteria, so it can’t infect you.
Scientists developed Prevnar 20 because the 20 serotypes in the vaccine cause more than half of all cases of invasive pneumococcal disease (IPD) in people over 65. The seven serotypes that Prevnar 13 doesn’t contain cause roughly 40%⁸ of all US cases of pneumococcal disease. More than 100 distinct variants of Streptococcus pneumoniae have been discovered.
A 2021 study⁹ discussed how PCVs have significantly reduced pneumococcal disease, but there were still huge problems with non-PCV serotype infections. Researchers investigated the safety and efficacy of PCV20 by comparing it to Prevnar 13 and Pneumovax 23.
They concluded that it was well tolerated, safe, and expected to improve protection against pneumococcal disease in adults.
An analysis¹⁰ shows that Prevnar 20 produced a comparable immune response to all 13 serotypes that it shares with Prevnar 13 one month after vaccination in adults aged 60 and older. Researchers identified similar results in response to six of the seven serotypes it shares with Pneumovax 23.
Six clinical trials studied Prevnar 20 before it was FDA-approved. These studies discovered the side effects were similar for all ages, and most were mild to moderate.
As with many other vaccines, the most common side effect is pain at the injection site. This presents as redness, swelling, pain, or tenderness.
Additional common side effects of Prevnar 20 include:
Muscle and joint pain
Most of these side effects happened within seven to ten days of receiving the vaccine.
Less than 2% of people experienced one or more severe adverse effects within six months, although these may not be connected to the vaccine.
While the CDC recommends vaccination against pneumococcus, there may be times when the vaccine is inappropriate for you.
Children younger than two years old should not be given PPSV23. Anyone younger than 18 years old should not be given PCV15 or PCV20.
If you’ve ever had a severe allergic reaction (anaphylaxis) to any of the vaccine’s ingredients, you should not receive Prevnar 20. The vaccine contains diphtheria protein, so if you had an allergic reaction to DTaP, avoid this vaccine.
Tell your doctor if you have any life-threatening allergies. They will check the ingredients to ensure the vaccine is safe for you.
You can likely get vaccinated if you have a mild illness, such as a cold. However, if you have a more serious illness, you should wait until you recover. Your doctor will be able to advise you if you can get vaccinated.
Your first port of call should be your doctor’s office. However, you can ask them for a referral if they don't have pneumococcal vaccines. Other places to try include:
Community health clinics
Prevnar 13® is part of the routine immunization schedule for children. You should easily be able to find the vaccine at:
Community health clinics
Pediatric and family practices
Public health departments
Another option is to contact your state health department to find out where to get pneumococcal vaccines in your community.
While no vaccine is 100% effective at preventing disease, the FDA considers all four pneumococcal vaccines safe and effective.
Pneumococcus is a dangerous bacteria that causes pneumonia and meningitis, among other illnesses. 2.5 million people died from pneumonia in 2019, and around 15% of children who contract meningitis die. That’s why it’s crucial to get vaccinated, and Prevnar 20 is a ground-breaking vaccine that can give us further protection.
Scientific research has declared Prevnar 20 safe and effective, with mild side effects. If you have any questions about the vaccine and your eligibility, speak to your healthcare provider.
Prevnar 20 | U.S. Food & Drug Administration
Pneumonia: Pneumonia mortality rates by age | Our World in Data
Pneumonia | Our World in Data
Pneumococcal disease | Oxford Vaccine Group
Pneumonia | World Health Organization
Pneumococcal vaccination: What everyone should know | Centers for Disease Control and Prevention (CDC)
A phase 3, randomized, double-blind study to evaluate the immunogenicity and safety of 3 lots of 20-valent pneumococcal conjugate vaccine in pneumococcal vaccine-naive adults 18 through 49 years of age (2021)
Pivotal phase 3 randomized clinical trial of the safety, tolerability, and immunogenicity of 20-valent pneumococcal conjugate vaccine in adults aged ≥18 years (2021)
Prevnar 20 (pneumococcal 20-valent conjugate vaccine), suspension for intramuscular injection | U.S. Food & Drug Administration
Number of deaths from pneumonia in children under 5, 2019 | Our World in Data
Two new pneumococcal vaccines—Prevnar 20 and vaxneuvance (2021)
For laboratorians | Centers for Disease Control and Prevention (CDC)
Health department directories | Centers for Disease Control and Prevention (CDC)
Prevnar 20 pneumococcal 20 - valent conjugate vaccine | Pfizer
Causes of pneumonia | Centers for Disease Control and Prevention (CDC)
Factsheet about pneumococcal disease | European Centre for Disease Prevention and Control
Understanding how vaccines work | Centers for Disease Control and Prevention (CDC)
Victoria is a writer from the UK with a keen interest in health and science. She loves writing about mental health, scientific advancements, and dispelling pseudoscience. When she’s not writing sass-laden articles, she walks her rescue dogs, giggles at anxiety memes, eats chocolate, and absorbs useless knowledge for quiz shows.
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