The CDC AdCom recommended for pneumococcal vaccination in all adults older than 50 years and in 19–49 year olds with certain underlying conditions, risk factors and vaccination history. Image credit: Tada Images / Shutterstock.

A US Centers for Disease Control and Prevention’s (CDC) Advisory Committee (AdCom) on Immunization Practice (ACIP) voted in favour of lowering the recommended age for pneumococcal vaccines to 50 years, down from 65.

The recommendation, backed by CDC director Mandy Cohen, affects approved pneumococcal vaccines such as MSD (Merck & Co)’s Capvaxive and Pfizer’s Prevnar 20. Currently, the CDC recommends pneumococcal vaccination for adults aged 65 years and older, as well as in young adults aged 19 through 65 with certain risk conditions.

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Prevnar 20 (20-valent pneumococcal conjugate vaccine/PCV20) was approved by the US Food and Drug Administration (FDA) for adults over 18 years of age in 2021. Two years later, the agency expanded the vaccine label to include infants and children, between six weeks and 17 years of age. Prevnar generated $6.4bn in sales last year, according to Pfizer’s financials. GlobalData expects the vaccine to continue to maintain comparable sales of $6.3bn in 2030.

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MSD’s Capvaxive (21-valent pneumococcal conjugate vaccine/PCV21) gained received an FDA accelerated approval in June. The vaccine is indicated for prevention of pneumonia caused by 22 serotypes of S. pneumoniae based on immune responses as measured by opsonophagocytic activity (OPA).

Although the AdCom voted in favour of lowering the recommended age for vaccination, a few experts were against including PCV20 in the update noting that the newer PCV21 was more cost effective. Pfizer’s PCV20 vaccine is priced at $262/dose compared to MSD’s PCV21 valued at $287/dose, according to the pricing model presented at the CDC AdCom meeting.

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MSD was quick to note that Capvaxive “covers the serotypes responsible for approximately 84% of invasive pneumococcal disease (IPD) cases, compared to approximately 52% covered by PCV20, based on CDC epidemiologic data”. Whilst Pfizer highlighted that Prevnar 20, unlike Capvaxive, helps prevent serotype 4 disease, an emergent strain of S. pneumoniae that has been responsible for causing IPD in certain parts of the US.

The AdCom recommendations are not binding and will only be official after being reviewed and finalised by the director of the CDC and the Department of Health and Human Services.