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HomePrevnar 20®Prevnar 20® Serotypes matterBurden of diseaseIPDCAPPatient profilesPatient
profiles
Age 50+: Arlene, Age 51Diabetes: David, Age 46Asthma: Carly, Age 30COPD: William, Age 48Age 65+: Tyrell, Age 67 Risk for All Underlying Medical ConditionsMary, 65: Healthy ≥65; Unknown Vaccination History
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Prescribing InformationIndicationsPatient SiteOrder Prevnar 20®
Access & support95% of commercial lives have coverage for Prevnar 20® (Pneumococcal 20-valent Conjugate Vaccine)1*Prevnar 20® is covered by commercial health plans and Medicare

*As of August 2024.

Under the Affordable Care Act, non-grandfathered commercial health plans cover Advisory Committee on Immunization Practices (ACIP) recommended vaccines without requiring a copayment or coinsurance.2 $0 cost share applies when the vaccine is administered by an in-network provider.3
As of January 2022, ACIP first published their recommendations for use of Prevnar 20 in the Morbidity and Mortality Weekly Report.4 It was later updated in September 2023 to include expanded use in certain previously vaccinated patients.5 In October 2024, ACIP recommended Prevnar 20 for use in adults aged 50 years or older in addition to those aged 19 to 49 with certain underlying medical conditions or other risk factors† who have not previously received a pneumococcal conjugate vaccine or whose previous vaccination history is unknown.6

Pfizer Vaccines Reimbursement Support Services can assist with benefit investigations.
Phone: (866) 744-3198, Monday to Friday, 8:00
AM – 8:00 PM Eastern Time

Prevnar 20 is covered by MedicareMedicare Fee-for-Service (FFS)
  • Medicare began covering Prevnar 20 on October 1, 20217
  • Pneumococcal vaccines covered under Part B are available to Medicare beneficiaries at $0 out of pocket8
Prevnar 20 is covered for the following patient types9: Medicare beneficiaries who are pneumococcal vaccine-naïve If eligible for a second vaccine, Medicare beneficiaries can receive a different, second pneumococcal vaccine 1 year after the first vaccine was administered based on CDC recommendations. Medicare Advantage (MA)
  • Represents approximately 43% of Medicare enrollees11
  • MA plans are required to cover all services covered by Medicare FFS12
    • $0 cost share applies when vaccine is administered by an in-network provider8
References†Alcoholism; chronic heart disease (including CHF and cardiomyopathies); chronic liver disease; chronic lung disease (including COPD, emphysema, and asthma); chronic renal failure; cigarette smoking; cochlear implant; congenital or acquired asplenia; cerebrospinal fluid leak; diabetes; generalized malignancy; HIV infection; Hodgkin disease; congenital or acquired immunodeficiency (includes B- [humoral] or T-lymphocyte deficiency, complement deficiencies [particularly C1, C2, C3, and C4 deficiencies], and phagocytic disorders [excluding chronic granulomatous disease]); iatrogenic immunosuppression (diseases requiring treatment with immunosuppressive drugs, including long-term systemic corticosteroids and radiation therapy); leukemia; lymphoma; multiple myeloma; nephrotic syndrome; solid organ transplant; sickle cell disease or other hemoglobinopathies.6
Access & SupportOrder Prevnar 20 for your office by registering for Prime. Get started LoadingOne dose of Prevnar 20 can help protect your eligible adult patients against pneumococcal pneumonia6,10
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Order Prevnar 20 for your office by registering for Prime Get started LoadingOne dose of Prevnar 20 can help protect your eligible adult patients against pneumococcal pneumonia.4 Discover administration details LoadingLearn about Prevnar 20 coverage in your area. View coverage Loading
CDC=Centers for Disease Control and Prevention; CHF=congestive heart failure; COPD=chronic obstructive pulmonary disease; CSF=cerebrospinal fluid; HIV=human immunodeficiency virus.†Alcoholism; chronic heart disease (including CHF and cardiomyopathies); chronic liver disease; chronic lung disease (including COPD, emphysema, and asthma); chronic renal failure; cigarette smoking; cochlear implant; congenital or acquired asplenia; cerebrospinal fluid leak; diabetes; generalized malignancy; HIV infection; Hodgkin disease; congenital or acquired immunodeficiency (includes B- [humoral] or T-lymphocyte deficiency, complement deficiencies [particularly C1, C2, C3, and C4 deficiencies], and phagocytic disorders [excluding chronic granulomatous disease]); iatrogenic immunosuppression (diseases requiring treatment with immunosuppressive drugs, including long-term systemic corticosteroids and radiation therapy); leukemia; lymphoma; multiple myeloma; nephrotic syndrome; solid organ transplant; sickle cell disease or other hemoglobinopathies.6Immunocompromising conditions.6References:Data on file. Managed market insights database. Pfizer Inc. Schwartz K, Freed M, Cubanski J, et al. Vaccine coverage, pricing, and reimbursement in the U.S. Kaiser Family Foundation (KFF). November 18, 2020. Accessed September 30, 2021. https://www.kff.org/report-section/vaccine-coverage-pricing-and-reimbursement-in-the-u-s-issue-briefCenters for Disease Control and Prevention. Resources for adult vaccination insurance and payment. August 9, 2024. Accessed November 15, 2024. https://www.cdc.gov/vaccines-adults/hcp/adult-payment-insurance-resources/index.htmlKobayashi M, Farrar JL, Gierke R, et al. Use of 15-valent pneumococcal conjugate vaccine and 20-valent pneumococcal conjugate vaccine among U.S. adults: updated recommendations of the Advisory Committee on Immunization Practices — United States, 2022. MMWR Morb Mortal Wkly Rep. 2022;71(4):109-117. Kobayashi M, Pilishvili T, Farrar JL, et al. Pneumococcal vaccine for adults aged ≥19 years: recommendations of the Advisory Committee on Immunization Practices, United States, 2023. MMWR Recomm Rep 2023;72(No. RR-3):1-39. Centers for Disease Control and Prevention. Pneumococcal vaccine timing for adults. October 2024. Accessed November 13, 2024. https://www.cdc.gov/pneumococcal/downloads/Vaccine-Timing-Adults-JobAid.pdfCenters for Medicare & Medicaid Services. MLNConnects. October 14, 2021. Accessed November 14, 2024. https://www.cms.gov/files/document/2021-10-14-mlnc.pdfMedicare.gov. Pneumococcal shots. Accessed November 20, 2024. https://www.medicare.gov/coverage/pneumococcal-shotsDepartment of Health & Human Services. CMS Manual System. Pub 100-02 Medicare Benefit Policy. Transmittal 202. https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R202BP.pdfPrevnar 20® (Pneumococcal 20-valent Conjugate Vaccine) Prescribing Information, Wyeth Pharmaceuticals LLC, 2023. Data.cms.gov. Monthly Medicare Enrollment Dashboard. August 2021. Accessed August 22, 2024. https://data.cms.gov/tools/medicare-enrollment-dashboardMedicare.gov. Understanding Medicare Advantage Plans. Accessed August 22, 2024. https://www.medicare.gov/Pubs/pdf/12026-Understanding-Medicare-Advantage-Plans.pdf
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INDICATIONS AND SELECT SAFETY INFORMATION
  • Prevnar 20® is indicated for active immunization for the prevention of invasive disease caused by Streptococcus pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 8, 9V, 10A, 11A, 12F, 14, 15B, 18C, 19A, 19F, 22F, 23F, and 33F in individuals 6 weeks of age and older
  • Prevnar 20® is indicated for active immunization for the prevention of pneumonia caused by S. pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 8, 9V, 10A, 11A, 12F, 14, 15B, 18C, 19A, 19F, 22F, 23F, and 33F in individuals 18 years of age and older
  • The indication of Prevnar 20® for the prevention of pneumonia caused by S. pneumoniae serotypes 8, 10A, 11A, 12F, 15B, 22F, and 33F in individuals 18 years of age and older is approved under accelerated approval based on immune responses as measured by opsonophagocytic activity (OPA) assay. Continued approval for this indication may be contingent upon verification and description of clinical benefit in a confirmatory trial
  • Prevnar 13® is indicated for active immunization for the prevention of pneumonia and invasive disease caused by Streptococcus pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, and 23F in adults 18 years of age and older
Prevnar 13® Limitations of Use: Prevnar 13® will only help protect against S. pneumoniae serotypes in the vaccine

SELECT SAFETY INFORMATION
 
  • Do not administer Prevnar 20® or Prevnar 13® to individuals with severe allergic reaction (eg, anaphylaxis) to any component of Prevnar 20® or Prevnar 13® or to diphtheria toxoid
  • Safety and immunogenicity data on Prevnar 20® are not available for individuals in immunocompromised groups and vaccination should be considered on an individual basis. Based on experience with pneumococcal vaccines, individuals with altered immunocompetence may have reduced immune responses to Prevnar 20®
IMPORTANT SAFETY INFORMATION
  • Do not administer Prevnar 20® or Prevnar 13® to individuals with severe allergic reaction (eg, anaphylaxis) to any component of Prevnar 20® or Prevnar 13® or to diphtheria toxoid
  • Safety and immunogenicity data on Prevnar 20® are not available for individuals in immunocompromised groups and vaccination should be considered on an individual basis. Based on experience with pneumococcal vaccines, individuals with altered immunocompetence may have reduced immune responses to Prevnar 20®
  • Immunocompromised individuals or individuals with impaired immune responsiveness due to the use of immunosuppressive therapy may have reduced antibody response to Prevnar 13®
  • For Prevnar 20® in individuals 18 years of age and older, the most commonly reported solicited adverse reactions (>10%) were pain at the injection site, muscle pain, fatigue, headache, and arthralgia. Additionally, injection site swelling was also reported (>10%) in individuals 18 through 59 years of age
  • For Prevnar 13®, in adults 18 years of age and older, the most commonly reported solicited adverse reactions (>5%) were pain, redness, and swelling at the injection site, limitation of arm movement, fatigue, headache, muscle pain, joint pain, decreased appetite, vomiting, fever, chills, and rash
Patients should always ask their healthcare providers for medical advice about adverse events. You are encouraged to report negative side effects of vaccines to the US Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC). Visit http://www.vaers.hhs.gov or call 1-800-822-7967.

Please click for Prevnar 20® Full Prescribing Information.

Please click for Prevnar 13® Full Prescribing Information.
INDICATIONS
  • Prevnar 20® is indicated for active immunization for the prevention of invasive disease caused by Streptococcus pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 8, 9V, 10A, 11A, 12F, 14, 15B, 18C, 19A, 19F, 22F, 23F, and 33F in individuals 6 weeks of age and older
  • Prevnar 20® is indicated for active immunization for the prevention of pneumonia caused by S. pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 8, 9V, 10A, 11A, 12F, 14, 15B, 18C, 19A, 19F, 22F, 23F, and 33F in individuals 18 years of age and older
  • The indication of Prevnar 20® for the prevention of pneumonia caused by S. pneumoniae serotypes 8, 10A, 11A, 12F, 15B, 22F, and 33F in individuals 18 years of age and older is approved under accelerated approval based on immune responses as measured by opsonophagocytic activity (OPA) assay. Continued approval for this indication may be contingent upon verification and description of clinical benefit in a confirmatory trial
  • Prevnar 13® is indicated for active immunization for the prevention of pneumonia and invasive disease caused by Streptococcus pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, and 23F in adults 18 years of age and older
Prevnar 13® Limitations of Use: Prevnar 13® will only help protect against S. pneumoniae serotypes in the vaccine