CDC's ACIP Endorses Merck’s CAPVAXIVE™ for Pneumococcal Vaccination in Adults 50+

On October 23, 2024, Merck, known as MSD outside the United States and Canada, revealed that the CDC's Advisory Committee on Immunization Practices (ACIP) has updated adult pneumococcal vaccination guidelines. The new recommendations advocate for the use of CAPVAXIVE™ (Pneumococcal 21-valent Conjugate Vaccine) in adults aged 50 and above. This adjustment marks a significant shift from the previous age threshold of 65 years.

The revised ACIP guidelines suggest a single dose of CAPVAXIVE for the following groups:
- Adults aged 50 and above who have not previously received a pneumococcal conjugate vaccine or have an unknown vaccination history.
- Adults aged 19-49 with specific underlying medical conditions or risk factors who have not previously received a pneumococcal conjugate vaccine or have an unknown vaccination history.
- Adults aged 19 and above who began their pneumococcal vaccination series with PCV13 but have not completed all recommended doses of PPSV23.

Additionally, the guidelines recommend shared clinical decision-making for a supplemental dose of CAPVAXIVE for adults aged 65 and older who have completed their vaccine series with PCV13 and PPSV23.

CAPVAXIVE is intended for active immunization to prevent invasive disease and pneumonia caused by 24 specific serotypes of Streptococcus pneumoniae in adults aged 18 and older. It is indicated for preventing pneumonia caused by these serotypes in the same age group. However, CAPVAXIVE should not be given to individuals with severe allergies to any of its components or to diphtheria toxoid.

According to national CDC data from 2018 to 2022, CAPVAXIVE covers serotypes responsible for roughly 84% of invasive pneumococcal disease (IPD) cases in adults aged 50 and older, compared to about 52% coverage by PCV20. Although this data highlights the broader coverage of CAPVAXIVE, there are no comparative studies on the efficacy of CAPVAXIVE versus PCV20. It is also noted that in some high-risk populations in regions like Alaska, Colorado, New Mexico, Oregon, and the Navajo Nation, there is a higher prevalence of IPD caused by serotype 4, which is not included in CAPVAXIVE. However, other U.S. regions have not reported significant percentages of serotype 4.

The CDC's decision to lower the recommended vaccination age to 50 could be a pivotal change in medical practice, as stated by Dr. Eliav Barr, senior vice president and chief medical officer at Merck Research Laboratories. He highlighted that this recommendation could enhance equitable access to the vaccine and potentially increase vaccination rates, contributing to the prevention of invasive pneumococcal disease and pneumonia among adults.

The updated recommendations will be officially published on the CDC website following final reviews by the CDC director and the Department of Health and Human Services.

Regarding safety, individuals with altered immunocompetence, such as those undergoing immunosuppressive therapy, might exhibit a reduced immune response to CAPVAXIVE. Common adverse reactions reported in adults aged 18-49 include injection-site pain, fatigue, headache, myalgia, and swelling. For those aged 50 and older, the most common reactions are injection-site pain, fatigue, and headache.

CAPVAXIVE is Merck's 21-valent pneumococcal conjugate vaccine designed to combat the primary serotypes responsible for adult invasive pneumococcal disease, including unique serotypes that other vaccines do not cover. It is administered as a single dose. Pneumococcal disease, caused by Streptococcus pneumoniae, can lead to serious conditions like pneumonia, bacteremia, and meningitis, particularly in adults.

Merck, a leading biopharmaceutical company for over 130 years, focuses on developing innovative health solutions to prevent and treat diseases worldwide. The company is committed to advancing scientific research and fostering a diverse and inclusive global workforce, aiming for a healthier future for all communities.