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These two pneumonia vaccines are not identical! Which one you should get depends on your situation.
Release date:
2024-03-04
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Abstract
In China, 2.5 million people develop pneumococcal pneumonia each year, resulting in 125,000 deaths; among them, infants under one year of age and adults aged 50 and older account for the majority.
Children harbor Streptococcus pneumoniae more frequently than adults, carry it for longer periods, and are more likely to facilitate transmission among household members.
Streptococcus pneumoniae can cause infectious diseases such as meningitis, otitis media, endocarditis, and sepsis. In particular, invasive pneumococcal disease may lead to severe complications and even death.
According to a study published in 2018, approximately 294,000 children under the age of five worldwide died from pneumococcal infections, with roughly one child under five succumbing to pneumococcus every two minutes.
Moreover, in recent years, the emergence of pneumococcal resistance has made treatment increasingly challenging; when confronted with highly resistant strains, some infections have become untreatable. As early as 2017, the World Health Organization had already classified Streptococcus pneumoniae among the “deadly drug‑resistant bacteria that pose a serious threat to human health.”
Therefore, for pneumococcal disease, the pneumococcal vaccine—when administered—remains the most effective preventive measure.
Since the pneumococcal vaccine is so important, some parents may have already had their children vaccinated. However, due to logistical constraints or information asymmetry, they may have opted for the 23-valent pneumococcal vaccine at the time—raising the question:
Can someone who has already received the 23-valent pneumococcal vaccine still get the 13-valent one?
If you’re not yet 6 years old, you can still get vaccinated!
Expert consensus does not recommend pneumococcal polysaccharide vaccine (23-valent) for healthy children aged 2 years and older, as the benefits are limited. However, vaccination carries no known risks.
If a child has received the 23-valent pneumococcal vaccine before the age of six, they may also receive one dose of the domestically produced 13-valent pneumococcal vaccine, provided that at least eight weeks have elapsed since the previous 23-valent dose. (For individuals aged 2 to 64, the interval should be at least 8 weeks; for those aged 65 and older, the interval should be at least 1 year. Specific requirements shall be subject to the guidelines of the local vaccination clinic.)
The 23-valent and 13-valent pneumococcal vaccines may seem like the same vaccine, differing only in their “valence,” but in reality, they are quite distinct. The mere addition of the word “conjugate” sets them apart—they’re no longer the same family.
Polysaccharide vaccines and polysaccharide–protein conjugate vaccines
The effects of the two processes are vastly different.
Currently, pneumococcal vaccines available on the market can be classified into two types based on their manufacturing processes: polysaccharide vaccines and polysaccharide–protein conjugate vaccines. Among them, the 23-valent pneumococcal vaccine is a polysaccharide vaccine, while the 13-valent pneumococcal vaccine is a polysaccharide–protein conjugate vaccine.
Polysaccharide vaccines are prepared by extracting the capsular polysaccharides from bacteria; to the immune system, they are weak antigens. (A substance that stimulates the body to produce antibodies is called an antigen; a vaccine can be regarded as an antigen.) : Small in stature and with limited strength, the tiny punches it delivers have only a modest effect. Although antibodies are produced, they do not enable the immune system to develop long-lasting memory.
As antibody levels wane, the protective effect against the disease diminishes as well. Re‑vaccination at any age does not provide a “booster” effect on the previous dose; rather, it elicits a new antibody response.
For children under two years of age, the immune system is not yet fully developed and is far less “vigilant” than in adults, resulting in a weaker response to polysaccharide vaccines and difficulty in generating effective protective antibodies. Therefore, children under two are not suitable for receiving the 23-valent pneumococcal vaccine.
Polysaccharide‑protein conjugate vaccines work by covalently linking small‑molecule polysaccharides to large‑molecule proteins, with the protein serving as a carrier for the polysaccharide. Recently, the new 13‑valent pneumococcal vaccine, Vimenfeibao, has been launched in China. ® That’s exactly this kind of case—except that, in addition to having a carrier, it’s a dual‑carrier system, which is… The world’s first Bivalent polysaccharide conjugate vaccine.
When polysaccharides are conjugated with proteins, they become much more immunogenic, making them less likely to be underestimated by the immune system. The immune system readily generates antibodies and develops a strong memory response to these large complexes.
If the same vaccine is administered again in the future, it can provide a booster effect on previous doses, resulting in a faster onset of antibody production and higher antibody titers compared to the first dose.
Weimin Feibao ® Adopted TT (Tetanus toxoid carrier) and DT (Diphtheria toxoid carrier) Two types of carriers ， Fully leverage the advantages of different delivery platforms to effectively mitigate immune suppression that may arise from excessive use of a single platform. Superior immune efficacy . This vaccine this year Sales may be realized internally.
The 23-valent pneumococcal vaccine uses pneumococcal capsular polysaccharides as its antigenic component; therefore, it can elicit only B-cell–mediated immunity and does not induce T-cell–mediated immunity.
However, prior to the introduction of conjugate vaccines, the only vaccine available to prevent pneumococcal disease was the 23-valent pneumococcal polysaccharide vaccine. Thus, in the evolution of pneumococcal vaccines, conjugate vaccines can also be regarded as a technological advancement.
Further Reading ：
So, here’s the question. Since polysaccharide‑conjugate vaccines are so effective, can elderly individuals receive the 13‑valent pneumococcal vaccine?
This is the standard practice abroad: for older adults who have never received a pneumococcal vaccine, the recommended schedule is to administer a single dose of the 13-valent pneumococcal vaccine, followed by the 23-valent pneumococcal vaccine at least one year later.
However, it is somewhat regrettable that, in China, the 13-valent pneumococcal conjugate vaccine has so far been approved only for children aged 6 weeks to 5 years; vaccination for older adults has not yet been authorized.
At present, the only pneumococcal vaccine available to older adults in China is the 23-valent polysaccharide vaccine. However, there is no need to worry: this vaccine can still reduce the risk of invasive pneumococcal disease and community-acquired pneumonia (CAP), with an overall protective efficacy ranging from 50% to 80%. For older adults who are unable to receive the 13-valent pneumococcal vaccine, the 23-valent formulation remains the best option.
The 2020 edition of the “Expert Consensus on Immunoprophylaxis of Pneumococcal Diseases,” developed by the Chinese Society of Preventive Medicine, recommends that older adults… Routine vaccination 23-valent pneumococcal vaccine.
In recent years, an increasing number of cities—including Beijing, Shanghai, and Kunming—have begun offering the 23-valent pneumococcal vaccine free of charge to residents aged 60 and older. However, due to insufficient public awareness among the elderly, only a small minority are aware of the vaccine or have received it. During the Two Sessions in 2020, CPPCC National Committee member Feng Danlong called for giving elderly‑specific vaccines the same priority as childhood vaccines. He stated that strengthening vaccination coverage among China’s aging population and raising overall vaccination rates to shift disease prevention upstream is a viable approach.
It should be noted that, In addition to routine vaccination for the elderly, the 23-valent pneumococcal vaccine is also indicated for individuals with high-risk factors, including children aged 2 years and older.
Specific high-risk factors are listed in the table below:
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Individuals with chronic cardiovascular disease (including congestive heart failure and cardiomyopathy), chronic lung disease (including chronic obstructive pulmonary disease and emphysema), or diabetes.
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Individuals with alcohol intoxication, chronic liver disease (including cirrhosis), and cerebrospinal fluid leakage.
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Individuals with functional or anatomical asplenia (including those with sickle cell disease and splenectomy)
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Individuals with compromised immune function (including those infected with HIV, patients with leukemia, lymphoma, Hodgkin’s disease, multiple myeloma, other malignancies, chronic renal failure, or nephrotic syndrome)
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Patients undergoing immunosuppressive chemotherapy (including corticosteroids) as well as organ or bone marrow transplant recipients.
The “Chinese Expert Consensus on the Diagnosis, Treatment, and Prevention of Streptococcus pneumoniae Disease in Children” recommends that children aged 2 years and older who are at high risk receive a 23-valent pneumococcal vaccine after completing the 13-valent pneumococcal vaccination series, thereby broadening the spectrum of serotypes covered by immunoprotection.
Therefore, the 23-valent pneumococcal vaccine and the 13-valent pneumococcal vaccine are not one-size-fits-all; for example, the 23-valent vaccine is intended only for older adults, while the 13-valent vaccine is reserved for children.
For children under 6 years of age, parents should first consider vaccinating their child with the 13-valent pneumococcal vaccine.
Whether children need to receive the 23-valent pneumococcal vaccine depends on their individual health status; if they have high-risk factors, they should be vaccinated with this vaccine. For specific guidance, please consult a physician at your local vaccination clinic.
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