Question: Is there a difference between pneumococcal vaccines? Answer: Since 2005, Centers for Medicare and Medicaid Services required nursing home to ensure that their residents receive pneumococcal vaccinations. Facilities must offer pneumococcal bacteria: Prevnar, Prevnar13(PCV13), Synflorix and Pneumovax23(PPSV23). There are differences in the way that they are made. Prevnar, Prevnar 13 and Synflorix are conjugate vaccines, while Pneumovax23 is polysaccharide vaccines. Prevnar offers protection against 7 common strains of pneumococcal bacteria, Synflroix against 10 types, Prevnar13 against 13 types and Pneumovax23 against 23 strains of the bacteria. According to recent guidelines, the Advisory Committee in Immunization Practices (ACIP) recommends sequential administration of 2 pneumococcal vaccines for adults over 65 years of age. CMS guidelines recommends the administration of Prevnar 13 followed by Pneumovax23 6 to 12 months later. Those in the 19 to 64 age group are still recommended to receive one dose of Pneumova23 every 5 years. The decision is based on age group and if the patient has been vaccinated previously.