New Pneumococcal Vaccine Recommendations

Karen Morris in Clinical & Quality

NYSDOH has posted the attached health advisory to the HCS.  Please review this advisory carefully with your Medical and Nursing staff. The advisory outlines the new recommendations from the CDC Advisory Committee on Immunization Practices (ACIP) related to pneumococcal vaccine for those 65 and over. A new vaccine, pneumococcal conjugate vaccine (PCV 13 - Prevnar 13) has been developed and it is now recommended that persons 65 or over receive both pneumococcal vaccines  (PCV 13 - Prevnar 13 and PPSV 23 – Pneumovax) and that they should first be vaccinated with new vaccine, pneumococcal conjugate vaccine (PCV 13 , Prevnar-13) and then vaccinated with the pneumococcal polysachiride vaccine (PPSV 23, Pneumovax 23) 12 months later. The two vaccines cannot be administered at the same time.

It is important to note that, at this time, Medicare Part B covers only one dose of pneumococcal vaccine, either PCV 13 or PPSV 23. Per the advisory, CMS has indicated that it would likely take a minimum of one year to enact a policy change for Medicare to cover both PCV 13 and PPSV 23 vaccine.

Key recommendations from the advisory are:

  • For those persons 65 or older, who have never received any pneumococcal vaccine or their vaccination status is unknown, they should be given the PCV 13 vaccine. 

  • It is recommended that those who have already received PPSV 23, at least one year ago, should now receive PCV 13, however, “healthcare providers should discuss with previously vaccinated patients the risks and benefits of administering PCV 13 vaccine at this time versus deferring vaccination until such time as it is covered by Medicare.”

  • For patients with private insurance, insurance companies have up to one year to include coverage based on the new recommendations.

Karen Morris
Director, Clinical & Quality Services
518-462-4800, ext. 15