The CDC’s Advisory Committee on Immunization Practices (ACIP) has recommended Merck’s recently approved 21-valent pneumococcal vaccine Capvaxive for adults 65 years and older, and for certain younger adults who have risk conditions or have already started a vaccine series.
Merck called the decision a “missed opportunity,” as the committee decided against broadening the recommendation to adults over 50 years old, at least for now. While ACIP discussed lowering the age recommendation, some speakers expressed concerns about making an already complicated recommendation more confusing.
“I think it would be really problematic to have a recommendation down to age 50 for a PCV21 vaccine and not for other high-valency pneumococcal vaccines such as PCV20,” said voting member Matthew Daley, who is a senior investigator at Kaiser Permanente’s Institute for Health Research. PCV20 is also known as Pfizer’s rival vaccine Prevnar 20.
Daley asked ACIP to discuss bringing down universal recommendations to age 50 for high-valency pneumococcal vaccines in October.
Capvaxive was approved last week for both the prevention of invasive pneumococcal disease and pneumococcal pneumonia. It was specifically designed for adults, and its strains covered 84% of invasive pneumococcal disease in patients 50 years and older between 2018 and 2021, according to Merck.
ACIP voted on Thursday to recommend the shot for adults 19 years and older who are currently recommended to receive a conjugated vaccine, including adults older than 65 and other adults with underlying conditions. That also includes certain adults 19 years and older who have started a pneumococcal vaccine series with PCV13, Merck said.
“We continue to believe in the evidence of the clinical benefit and value of Capvaxive to age 50,” the company said, noting that it looks forward to further ACIP discussion.
American Medical Association physician Sandra Fryhofer said during the ACIP meeting that the CDC’s pneumococcal recommendation is the “most complicated vaccination recommendation we have,” adding that “having a different age group for PCV20 than for PCV21 would add much confusion.”