Real-world data confirm PCV20 effectiveness against pneumococcal disease in adults aged ≥65 years

PCV20 demonstrated effectiveness with substantial reductions in cases of invasive pneumococcal disease and all-cause pneumonia in a cohort of more than 16 million individuals aged ≥65 years, according to a presentation from the ESCMID Vaccines 2025 conference.

Ms Amanda C. Miles (Pfizer Inc., NY, USA) reported a retrospective cohort study using insurance claims data (Medicare Parts A and B) carried out between July 2022 and June 2024. Adults aged ≥65 years were included if they had ≥1 year of continuous enrolment before the index date and ≥1 claim, and were excluded from time-segment calculations if they received PPSV23 ≤2 years, PCV13 ≤5 years prior, or PCV15. In total, the study enrolled 16.5 million adults, of whom 12.2% received PCV20 during follow-up.

The vaccine effectiveness against invasive pneumococcal disease was 25.6% (95% CI 19.5-31.3) overall, with similar results across risk subgroups (immunocompromised 25.0%, chronic medical conditions 22.6%, low-risk 33.8%). Furthermore, vaccine effectiveness against all-cause pneumonia was 15.2% (95% CI 14.6-15.8), with similar effectiveness in risk subgroups (immunocompromised 16.5%, chronic medical conditions 15.6%, low-risk 17.3%). Overall, PCV20 led to an adjusted reduction in invasive pneumococcal disease cases of 12.0 cases/100,000 patient-years (95% CI 8.0-16.0), with absolute reductions of 32.0, 13.2 and 12.0/100,000 patient-years in immunocompromised, chronic medical condition, and low-risk subgroups, respectively. Similarly, PCV20 led to absolute reductions of 758.0 cases/100,000 patient-years (95% CI 664.2-851.7) in all-cause pneumonia, with reductions of 1,864.1, 1,163.3, and 890.4 cases/100,000 patient-years among risk subgroups.

“PCV20 demonstrated effectiveness against invasive pneumococcal disease and substantial effectiveness against all-cause pneumonia among adults aged ≥65 years,” concluded Ms Miles. “This study provides the first data demonstrating PCV20 effectiveness among individuals in all risk groups, including those who are immunocompromised. PCV20 vaccination led to substantial absolute rate reductions, driven by prevention of all-cause pneumonia cases, particularly in individuals at increased risk of disease.”

1. Miles AC, et al. Real-world effectiveness of 20-valent pneumococcal conjugate vaccine among older adults in the United States by risk group. 6^th ESCMID Vaccines, 10–13 September 2025, Lisbon, Portugal.

Medical writing support was provided by Mihai Surducan, PhD.

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Posted on 15 September 202521 October 2025