Prevnar 13 vs. Pneumovax 23: Differences, similarities, and which is better for you

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

Pneumonia is an infection of one or both lung(s), which can be life-threatening, especially in infants and children, patients who are immunocompromised, and adults over 65. According to the CDC, about 50,000 people die in the US every year from pneumonia. Prevnar 13 and Pneumovax 23 are two brand-name vaccines approved by the FDA. Both vaccines are used to prevent pneumococcal pneumonia and its complications, but they have some differences such as how they are administered, and the types of bacteria they protect against. Let’s compare the two below.

What are the main differences between Prevnar 13 and Pneumovax 23?

Prevnar 13 and Pneumovax 23 are both brand-name vaccines. Prevnar 13 (Prevnar 13 coupons | What is Prevnar 13?) is also known as pneumococcal 13-valent conjugate vaccine injection (or PCV13)—it protects against 13 different types of pneumococcal bacteria. Prevnar 13 is injected IM (into a muscle).

Pneumovax 23 (Pneumovax 23 coupons | What is Pneumovax 23?) is also known as pneumococcal vaccine polyvalent injection (or PPSV23 vaccine)—it protects against 23 types of pneumococcal bacteria. Pneumovax 23 can either be injected IM or SQ (subcutaneously, or under the skin).

You will likely receive one vaccine with Prevnar 13, and one vaccine with Pneumovax 23, about one year apart, as an adult.

Conditions treated by Prevnar 13 and Pneumovax 23

Prevnar 13 is indicated for:

Children six weeks through five years old (prior to the 6th birthday):

• Active immunization to prevent invasive disease caused by Streptococcus pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F and 23F
• Active immunization to prevent otitis media (ear infection) caused by S. pneumoniae serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F

Children 6 to 17 years old (prior to the 18th birthday):

• Active immunization to prevent invasive disease caused by S. pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F and 23F

Adults 18 years and older:

• Active immunization to prevent pneumonia and invasive disease caused by S. pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F and 23F

Pneumovax 23 is indicated for active immunization for the prevention of invasive pneumococcal disease that is 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). It is approved for use in patients ages 50 years or older, and patients ≥2 years old who are at increased risk for pneumococcal disease.

The ACIP (Advisory Committee on Immunization Practices) develops vaccine recommendations for the CDC (Centers for Disease Control and Prevention). More information from the CDC about pneumococcal vaccinations, including vaccine schedules, can be found here. CDC.gov is an informative and reputable site for vaccine information.

Is Prevnar 13 or Pneumovax 23 more effective?

We know that both Prevnar 13 and Pneumovax 23 are safe, and also effective in preventing pneumonia, so we look to the CDC for recommendations. Most adults over 65 will receive one dose of Prevnar 13 and one dose of Pneumovax 23, one year apart, with certain exceptions.

The basic recommended schedule is outlined below, but you can find more detailed information here.

The CDC recommends:

• Routine administration of Prevnar 13 for all children younger than 2 years of age as a four-dose series at ages two months (first dose of PCV13), four months (second dose), six months (third dose), and 12-15 months (fourth dose).
• Routine administration of Pneumovax 23 for all adults age 65 years or older.
• Administration of Prevnar 13 for adults age 65 years or older who do not have an immunocompromising condition, cerebrospinal fluid leak, or cochlear implant, and have never received a dose of Prevnar 13.

*For exceptions and catch-up schedule, see link above.

Consult your healthcare provider for guidance about pneumonia vaccines.

Coverage and cost comparison of Prevnar 13 vs. Pneumovax 23

Insurance coverage varies on both Prevnar 13 and Pneumovax 23. If you or your child receive a dose in your healthcare provider’s office, it may be covered under your medical insurance. Most pharmacies now provide vaccination services, including pneumonia vaccines, to adults, so you can conveniently get your vaccine at your local drugstore (tip—call before coming in, to make sure the pharmacist has time!). Medicare usually does not cover the cost of either vaccine.

Try the SingleCare prescription discount card

Without insurance, a dose of Prevnar 13 costs about $240, and a dose of Pneumovax 23 costs about $135. You can get Prevnar 13 about $195 and Pneumovax 23 for $109 by using a SingleCare discount card or coupon.

Common side effects of Prevnar 13 vs. Pneumovax 23

Side effects of Prevnar 13 vary based on age groups.

In infants and toddlers (2, 4, 6, and 12-15 months of age), the most common adverse reactions with Prevnar 13 are:

• Irritability (>70%)
• Injection site tenderness (>50%)
• Decreased appetite (>40%)
• Decreased sleep (>40%)
• Increased sleep (>40%)
• Fever (>20%)
• Injection site redness (>20%)
• Injection site swelling (>20%)

In young children five through 17 years of age, the most common adverse reactions with Prevnar 13 are:

• Injection site tenderness (>80%)
• Injection site redness (>30%)
• Injection site swelling (>30%)
• Irritability (>20%)
• Decreased appetite (>20%)
• Increased sleep (>20%)
• Fever (>5%)
• Decreased sleep (>5%)

In adults 18 years and older, the most common adverse reactions of Prevnar 13 are:

• Pain at the injection site (>50%)
• Fatigue (>30%)
• Headache (>20%)
• Muscle pain (>20%)
• Joint pain (>10%)
• Decreased appetite (>10%)
• Injection site redness (>10%)
• Injection site swelling (>10%)
• Limitation of arm movement (>10%)
• Vomiting (>5%)
• Fever (>5%)
• Chills (>5%)
• Rash (>5%)

The most common side effects associated with Pneumovax 23 are:

• Injection-site pain, soreness, or tenderness (60.0%)
• Injection-site swelling or induration (hardening) (20.3%)
• Headache (17.6%)
• Injection-site redness (16.4%)
• Weakness or fatigue (13.2%)
• Muscle pain (11.9%)

This is not a full list of side effects—other side effects may occur. Contact your healthcare provider for a full list of side effects that may occur with Prevnar 13 or Pneumovax 23.

Source: DailyMed (Prevnar 13), DailyMed (Pneumovax 23)

Drug interactions of Prevnar 13 vs. Pneumovax 23

In children and adolescents, there is not enough data to know if Prevnar 13 can be given at the same time as Human Papillomavirus Vaccine (HPV), Meningococcal Conjugate Vaccine (MCV4) and Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine, Adsorbed (Tdap).

In adults, no data is available on the administration of Prevnar 13 together with diphtheria toxoid-containing vaccines and other vaccines used in adults 50 years and older.

When Prevnar 13 is administered at the same time as another injectable vaccine, the vaccines should be administered with different syringes and injected at different sites. Prevnar 13 should not be mixed with other vaccines in the same syringe.

Giving Tylenol (acetaminophen) before Prevnar 13 may reduce the body’s response to the vaccine. Patients who are immunocompromised due to immunosuppressive therapy (irradiation, corticosteroids, antimetabolites, alkylating agents, and cytotoxic agents) may not respond optimally to the vaccine.

Patients receiving the shingles vaccine, Zostavax, may have a lower immune response when receiving the vaccine at the same time as Pneumovax 23. The two vaccines should be separated by at least 4 weeks. This should rarely be an issue, though, as Shingrix is now the preferred shingles vaccine. There is limited data regarding other vaccines given at the same time as Pneumovax 23. Consult your healthcare provider for guidance.

RELATED: What is Tylenol? | What is Acetaminophen? | What is Shingrix?

Other interactions may occur. Consult your healthcare provider about the possibility of drug or vaccine interactions with Prevnar 13 or Pneumovax 23.

Warnings of Prevnar 13 and Pneumovax 23

Prevnar 13

• In some infants born prematurely, apnea has occurred following vaccination. If your child was born prematurely, consult with your healthcare provider about the benefits and risks of vaccination.
• The effectiveness of Prevnar 13 has not been established in infants born prematurely, children with sickle cell disease, patients with a recent hematopoietic stem cell transplant, or patients with HIV infection.
• Patients should not receive Prevnar 13 if they have had a severe allergic reaction to a vaccine made with diphtheria toxoid (such as DTaP) or another version of the pneumonia shot called PCV7 (Prevnar).

Pneumovax 23

• Patients who are feeling ill (moderate to severe) should not be vaccinated until feeling better.
• Patients with a history of severe allergic reaction to this vaccine should not receive the vaccine.
• Use caution in patients with severely compromised cardiovascular and/or pulmonary function.
• Patients who need antibiotic prophylaxis against pneumococcal infection will still need prophylaxis, even if receiving the vaccine.
• Patients with immunocompromising conditions (or taking immunosuppressant medication) may have a diminished response to the vaccine.
• Pneumovax 23 may not be effective for the prevention of pneumococcal meningitis in patients with chronic cerebrospinal fluid leak resulting from congenital lesions, skull fractures, or neurosurgical procedures.

Frequently asked questions about Prevnar 13 vs. Pneumovax 23

What is Prevnar 13?

Prevnar 13 is a vaccine made by Wyeth Pharmaceuticals and marketed by Pfizer Inc., that protects against 13 strains of pneumococcal bacteria.

What is Pneumovax 23?

Pneumovax 23 is a vaccine made by Merck & Co., Inc. that protects against 23 strains of pneumococcal bacteria.

Are Prevnar 13 and Pneumovax 23 the same?

Not quite. They both protect against pneumococcal bacteria. Prevnar 13 protects against 13 types of bacteria, and Pneumovax 23 protects against 23 types of bacteria. Prevnar 13 is given in the muscle (IM), while Pneumovax 23 can be given either in the muscle (IM) or under the skin (subcutaneously). Most adults over 65 will receive one dose of each vaccine, one year apart.

Is Prevnar 13 or Pneumovax 23 better?

Both vaccines are safe and effective in preventing pneumococcal infection. Most adults over 65 need one dose of each vaccine.

Can I use Prevnar 13 or Pneumovax 23 while pregnant?

There is not enough data about these vaccines in pregnancy. Talk to your OB-GYN to decide if you need a pneumonia vaccine before you get pregnant.

Can I use Prevnar 13 or Pneumovax 23 with alcohol?

The prescribing information for both vaccines does not mention the use of alcohol. Consult your healthcare provider.

Do I need both PCV13 and PPSV23?

Yes, receiving one dose of each vaccine is important to lower the risk of pneumonia. However, the CDC recommends against getting PCV13 and PPSV23 at exactly the same time. If you do need both vaccines, the CDC recommends getting PCV13 first, followed by a shot of PPSV23 at another visit. Ask your healthcare professional when you should come back for the second vaccine.

How many years is a pneumonia shot good for?

It is important to get your pneumonia vaccines, especially if you are over 65 and/or have certain medical conditions/risk factors (high-risk patients include those who smoke or have asplenia, chronic liver disease, nephrotic syndrome or renal failure, asthma, chronic lung disease, chronic heart disease, or diabetes mellitus). It is recommended that you get one dose of each vaccine, one year apart, which will provide immunity for many years.

How often should adults get Prevnar 13? / How long does Prevnar last?

Prevnar 13 is a one-time vaccine for older adults. Consult your healthcare provider to see if you need a vaccination with Prevnar 13 and/or Pneumovax 23. Also, be sure to get your flu shot every year, and ask your healthcare provider if you are due for any other immunizations.