Prevnar 20 is a vaccine 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 older¹
• Active immunization for the prevention of otitis media caused by S. pneumoniae serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F in children 6 weeks through 5 years of age¹

• IPD can potentially lead to serious illness in young children. Clinical presentations can include meningitis and bacteremia²
• S. pneumoniae is the leading cause of bacterial meningitis among children <5 years of age in the US²
• Bacteremia without a known site of infection is the most common invasive clinical presentation of pneumococcal infection among children aged 2 years or younger²

OM is one of the most frequent reasons for pediatric office visits, leading to over 10 million visits annually. OM can cause significant disruptions in children’s health²:

• A leading cause of emergency room visits³
• The most common reason for tympanostomy tube insertion, the most common ambulatory surgery performed on children in the United States⁴
• A common reason for antibiotic use in children <5 years of age.^5,6 Recent antibiotic use can contribute to risk for resistant infections⁷
• A cause of hearing loss or impairment⁸

Acute otitis media is the most common clinical presentation of pneumococcal disease in young children.^2,9

Prevnar 20 is the only PCV indicated to help prevent otitis media, covering 7 OM-causing S. pneumoniae serotypes.^1,10*

Learn more about the burden of disease by clicking here.

Prevnar 20 is built on the efficacy already achieved by Prevnar^® (Pneumococcal 7-valent Conjugate Vaccine [Diphtheria CRM₁₉₇ Protein]). Prevnar (PCV7) demonstrated a 97.4% reduction in IPD per protocol in the clinical study.^1,11

Learn more about efficacy.

CDC surveillance data show a 97% reduction in IPD caused by the serotypes covered by Prevnar 13 between 1998 and 2023, with a reduction from 87.4 cases per 100,000 to 2.8 cases per 100,000 in children <5 years old.¹²

In the US, Prevnar (PCV7) was available from 2000 to 2010, and Prevnar 13 was available from 2010 to 2024. Prevnar 20 has been available since 2023.^1,11

Learn more about real-world reductions in IPD.

• Prevnar 20 is indicated for active immunization for the prevention of invasive disease caused by the 20 S. pneumoniae serotypes included in the vaccine, including serotype 3¹

Following the 4-dose series, Prevnar 20 demonstrated a robust immunological response that included geometric mean immunoglobulin G (IgG) antibody concentrations to all 20 serotypes in the vaccine. Additionally, Prevnar 20 elicited a functional antibody response, which help facilitate the killing of disease-causing bacteria against all 20 serotypes included in the vaccine, following the third and fourth dose.¹

Prevnar 20 is built on the scientific foundation of Prevnar (PCV7) and Prevnar 13.¹ Prevnar 13 demonstrated real-world effectiveness against the 13 serotypes in the vaccine, including serotype 3.^1,11,13 A study in the US showed Prevnar 13 effectiveness of 58.4% (95% CI, 19.0%-79.0%) against IPD caused by serotype 3 in children <5 years of age who received ≥1 dose of PCV13.^13† The efficacy and effectiveness of Prevnar (PCV7) and Prevnar 13 are relevant to Prevnar 20 since Pfizer manufactured Prevnar (PCV7), Prevnar 13, and Prevnar 20 similarly.¹

As of January 2026, the most recent CDC Recommended Child and Adolescent Immunization Schedule includes Prevnar 20.^14,15

As of February 2026, the most recent AAP Recommended Child and Adolescent Immunization Schedule includes Prevnar 20. This schedule is published in the AAP Red Book.¹⁶

No additional doses are needed if Prevnar 20 was part of their completed PCV series. When Prevnar 20 is used, PPSV23 is not needed in children with certain underlying medical conditions.¹⁷

• Do not administer Prevnar 20 to individuals with a severe allergic reaction (eg, anaphylaxis) to any component of Prevnar 20 or to diphtheria toxoid¹
• 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 20¹
• Apnea following intramuscular vaccination has been observed in some infants born prematurely. Vaccination of premature infants should be based on the infant’s medical status and the potential benefits and risks¹
• In individuals 2, 4, 6, and 12 through 15 months of age vaccinated with a 4-dose schedule, the most commonly reported solicited adverse reactions (>10%) were irritability, pain at the injection site, drowsiness, decreased appetite, injection site redness, injection site swelling, and fever¹
• In individuals 15 months through 17 years of age vaccinated with a single dose, the most commonly reported solicited adverse reactions (>10%) were irritability, pain at the injection site, drowsiness, fatigue and muscle pain, decreased appetite, injection site swelling and redness, headache, and fever¹

Before administering Prevnar 20, please read the accompanying Prescribing Information. The Patient Information is also available.

• Prevnar 20 should not be administered to individuals who have had a severe allergic reaction (such as anaphylaxis) to any component of the vaccine, including diphtheria toxoid¹

The safety and immunogenicity data for Prevnar 20 are not available for immunocompromised groups. Vaccination should be considered on an individual basis, as those with altered immunocompetence may have reduced immune responses to the vaccine.¹

Individuals with a history of altered immunocompetence may experience reduced immune responses to Prevnar 20, based on past experiences with pneumococcal vaccines. This needs to be considered when planning vaccination.¹

Prevnar 20 is recommended as a 4-dose series for new PCV starts.^‡§¶ Doses are administered at 2 months, 4 months, 6 months, and 12 to 15 months.¹⁷

To see the complete dosing schedule, please click this link.

Prevnar 20 can be used as a transition option for children aged 2 to 23 months who have started their pneumococcal vaccination series with a different vaccine, such as 15-valent pneumococcal conjugate vaccine (PCV15). It can also be used as an option for completing missed doses in children aged 24 to 59 months. In such cases, Prevnar 20 can help ensure that children receive the broadest serotype coverage available.^1,10,17

• Prevnar 20 can be used as an option for the full series or to complete the recommended schedule started with either Prevnar 13 or VAXNEUVANCE¹⁷

• No, healthy children who have already completed the series with a PCV do not need a dose of Prevnar 20¹⁷

Several underlying medical conditions increase the risk for IPD in children. These conditions include:

• Cerebrospinal fluid leak
• Chronic heart disease
• Chronic kidney disease (excluding maintenance dialysis and nephrotic syndrome)
• Chronic liver disease
• Chronic lung disease (including moderate to severe persistent asthma)
• Cochlear implants
• Diabetes mellitus
• Immunocompromising conditions (such as those requiring maintenance dialysis or with nephrotic syndrome; congenital or acquired asplenia or splenic dysfunction; congenital or acquired immunodeficiencies; conditions treated with immunosuppressive drugs or radiation therapy, including malignant neoplasms, leukemias, lymphomas, Hodgkin disease, and solid organ transplants; HIV infection; and sickle cell disease and other hemoglobinopathies)¹⁷

Click here to review the dosing schedule for Prevnar 20.

Yes, the CDC has made Prevnar 20 available to eligible children through the VFC program. Children qualify for the VFC program if they are less than 19 years of age and either uninsured, underinsured, Medicaid eligible, or American Indian or Alaska Native. This means that patients who may have an inability to pay for the vaccine may be able to get it for free. In fact, all grantees currently allow for ordering.^18-20

Pediatric vaccination rates lag among babies who are publicly insured and those experiencing poverty.²¹

By participating in the VFC program, providers can offer pneumococcal vaccines such as Prevnar 20 to eligible children at no cost to their families. This program aligns your practice with public health initiatives focusing on reducing vaccine-preventable diseases.^18,19

To learn more about vaccination rates, please click here.

Prevnar 20 is administered as a 0.5 mL dose via intramuscular injection. It should be injected using a sterile needle attached to the pre-filled syringe provided.¹

Prevnar 20 should be stored refrigerated at temperatures between 2 ºC to 8 ºC (36 ºF to 46 ºF). It may arrive at temperatures between 2 ºC to 25 ºC (36 ºF to 77 ºF) after shipping but must be kept refrigerated upon receipt. It is important not to freeze Prevnar 20, and if the vaccine has been frozen, it should be discarded. Additionally, the syringes should be stored horizontally in the refrigerator to minimize resuspension time.¹

Learn more about storage, handling, and administration for Prevnar 20.

• CPT Code: 90677¹

For new customers, please call 1-800-666-7248 or click here to order on Pfizer Prime

An NDC for Prevnar 20 is provided to facilitate ordering¹:

• NDC 0005-2000-10 for a package of 10 pre-filled syringes

Yes.

Prevnar 20 for pediatric patients is covered for the majority of eligible patients under commercial health plans in the US.²² Most private insurance plans include this vaccine as part of preventive care.²³ Always confirm coverage details with the patient’s health plan and verify in-network vaccine providers. For more information, please click here to learn about health plan coverage for Prevnar 20.

For uninsured or underinsured pediatric patients:

• Children may be eligible to receive Prevnar 20 through the VFC program, which provides vaccines at no cost to eligible families who cannot afford them^18,19

Additional Information:

• Under the Affordable Care Act (ACA), payers are required to cover ACIP-recommended preventive vaccines with no out-of-pocket cost to patients²⁴
• To ensure accurate claim processing, work with your billing administrator to confirm that billing systems and electronic health records (EHRs) reflect the latest pediatric indication for Prevnar 20, including appropriate CPT and NDC codes
• Payer policies can change frequently, so always consult the individual payer for the most current coverage details