Cost information for CAPVAXIVE

Figuring out what you might pay out-of-pocket for a vaccination can be confusing. What you pay will depend on many factors, including your insurance situation and if there are financial support options available to you. At Merck, we believe that you should be better able to understand what you can expect to pay out of your own pocket for your shot.

The list price for each indicated dose of CAPVAXIVE is $301.35.a Most people will not pay the list price, although it may have an impact on your out-of-pocket costs. The amount you pay will depend on many factors, including your insurance situation. The information below will help you better estimate what you may pay for your vaccination based on your insurance situation.b For the actual out-of-pocket cost of your vaccine, talk to your insurance provider, who knows the details of your plan if you have insurance, or contact your health care provider’s office for help.

CAPVAXIVE is a shot that is given into the muscle (usually in your upper arm). CAPVAXIVE is given as one shot.

aThe list price is current as of August 2025. The list price does not include other treatment-related costs, such as vaccine administration fees.

bThe out-of-pocket costs below do not include costs associated with administration of CAPVAXIVE.

Choose an option below that best describes your insurance situation:

Commercial or private insurance

Vaccination in doctor’s office

I have commercial insurance through an employer or private policy that covers CAPVAXIVE.

For patients with commercial insurance, 99.1% of patients paid no out-of-pocket costs for a shot of CAPVAXIVE. For those patients who did have out-of-pocket costs, 80% of patients paid between $4.52 and $335.53 for a shot of CAPVAXIVE.*

*IQVIA™ Patient Cost Disclosure data for the period October 2024 to September 2025 sourced from commercial, Medicare, and IQVIA Medicaid claims. Commissioned by Merck Sharp & Dohme LLC, IQVIA’s analysis is based on remittance data that provide claim payment information after medical claims have been processed by the patient’s medical insurer and assigned to primary payer channel. The data are limited to remittance transactions on medical claims collected by IQVIA and may not constitute a nationally representative sample. IQVIA estimates the sample size covers roughly 10-15% of all claims. Please note that a patient’s cost may differ from the amounts depicted above.

Vaccination in pharmacy

I have commercial insurance through an employer or private policy that covers CAPVAXIVE.

For patients with commercial insurance, 99.3% of patients paid no out-of-pocket costs for a shot of CAPVAXIVE. For those patients who did have out-of-pocket costs, 80% of patients paid between $1 and $290.45 for a shot of CAPVAXIVE.†

†IQVIA™: Patient Cost Disclosure data for the period October 2024 to September 2025 reflecting real-world claims activity for administration from retail pharmacies for which data are available in the IQVIA™: Patient Cost Disclosure database. Reported ranges are based on actual final patient out-of-pocket costs (for commercially insured patients) for patients vaccinated with CAPVAXIVE. Reported ranges include both paid and reversed claims for vaccinations for which data are available. Data accessed as of September 2025. All rights reserved. Please note that a patient’s cost may differ from the amounts depicted above.

Medicare

Vaccination in doctor’s office

I have coverage for CAPVAXIVE through Medicare.

For patients with Medicare (Medicare Advantage + Medicare A + Medicare B) coverage, 98.8% of patients paid no out-of-pocket costs for a shot of CAPVAXIVE. For those patients who did have out-of-pocket costs, 80% of patients paid between $7.50 and $311.50 for a shot of CAPVAXIVE.*

*IQVIA™ Patient Cost Disclosure data for the period October 2024 to September 2025 sourced from commercial, Medicare, and IQVIA Medicaid claims. Commissioned by Merck Sharp & Dohme LLC, IQVIA’s analysis is based on remittance data that provide claim payment information after medical claims have been processed by the patient’s medical insurer and assigned to primary payer channel. The data are limited to remittance transactions on medical claims collected by IQVIA and may not constitute a nationally representative sample. IQVIA estimates the sample size covers roughly 10-15% of all claims. Please note that a patient’s cost may differ from the amounts depicted above.

Vaccination in pharmacy

I have coverage for CAPVAXIVE through Medicare.

For patients with Medicare Part D coverage, 99.9% of patients paid no out-of-pocket costs for a shot of CAPVAXIVE. For those patients who did have out-of-pocket costs, 80% of patients paid between $1 and $37 for a shot of CAPVAXIVE.‡

  • What you pay for CAPVAXIVE will largely depend on your insurance plan. Each Medicare prescription drug benefit plan has a different out-of-pocket cost for the medicines it covers and could include an annual deductible. If you haven’t met your deductible, you may pay a higher out-of-pocket cost and could pay an amount closer to the list price above until you meet your deductible. If you need assistance to understand your Medicare prescription drug coverage and out-of-pocket costs, contact your Medicare Plan Sponsor. If you need access to Medicare Part D coverage, visit https://www.medicare.gov/drug-coverage-part-d

‡IQVIA™: Patient Cost Disclosure data for the period October 2024 to September 2025 reflecting real-world claims activity for administration from retail pharmacies for which data are available in the IQVIA™: Patient Cost Disclosure database. Reported ranges are based on actual final patient out-of-pocket costs for patients vaccinated with CAPVAXIVE. Reported ranges include both paid and reversed claims for vaccinations for which data are available. For Medicare (Medicare D), low-income subsidy patients are included in out-of-pocket cost calculations. Data accessed as of September 2025. All rights reserved. Please note that a patient’s cost may differ from the amounts depicted above.

Medicaid

Vaccination in doctor’s office

I have coverage for CAPVAXIVE through Medicaid.

For patients with Medicaid (FFS + MGD), 99.5% of patients paid no out-of-pocket costs for a shot of CAPVAXIVE. For those patients who did have out-of-pocket costs, 80% of patients paid between $4 and $327.89 for a shot of CAPVAXIVE.* To learn more about Medicaid in your state and find out if you’re eligible, visit https://www.medicaid.gov/faq

*IQVIA™ Patient Cost Disclosure data for the period October 2024 to September 2025 sourced from commercial, Medicare, and IQVIA Medicaid claims. Commissioned by Merck Sharp & Dohme LLC, IQVIA’s analysis is based on remittance data that provide claim payment information after medical claims have been processed by the patient’s medical insurer and assigned to primary payer channel. The data are limited to remittance transactions on medical claims collected by IQVIA and may not constitute a nationally representative sample. IQVIA estimates the sample size covers roughly 10-15% of all claims. Please note that a patient’s cost may differ from the amounts depicted above.

Vaccination in pharmacy

I have coverage for CAPVAXIVE through Medicaid.

For patients with Medicaid (FFS + MGD), 99.9% of patients paid no out-of-pocket costs for a shot of CAPVAXIVE. For those patients who did have out-of-pocket costs, 80% of patients paid between $1 and $3 for a shot of CAPVAXIVE.§ Your out-of-pocket costs may vary if you have a higher income. To learn more about Medicaid in your state and find out if you’re eligible, visit https://www.medicaid.gov/faq

§IQVIA™: Patient Cost Disclosure data for the period October 2024 to September 2025 reflecting real-world claims activity for administration from retail pharmacies for which data are available in the IQVIA™: Patient Cost Disclosure database. Reported ranges are based on actual final patient out-of-pocket costs for patients vaccinated with CAPVAXIVE. Reported ranges include both paid and reversed claims for vaccinations for which data are available. For Medicaid Fee-for-Service (FFS) and Medicaid Managed Care (MGD), low-income subsidy patients are included in out-of-pocket cost calculations. Data accessed as of September 2025. All rights reserved. Please note that a patient’s cost may differ from the amounts depicted above.

No insurance

I don’t have insurance, or CAPVAXIVE is not covered by my insurance.

If you don’t have insurance coverage or if your insurance does not cover vaccination with CAPVAXIVE, you could pay an amount closer to the list price shown above, plus any additional charges depending on where you receive your vaccination.

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Learn about CAPVAXIVE

Learn about CAPVAXIVE

Get CAPVAXIVE

Get CAPVAXIVE

What is CAPVAXIVE?

CAPVAXIVE is a vaccine for individuals 18 years of age and older to help protect against invasive pneumococcal disease and pneumonia caused by certain types of bacteria called pneumococcus.

Important Safety Information

You should not get CAPVAXIVE® (Pneumococcal 21-valent Conjugate Vaccine) if you are allergic to any of the ingredients in CAPVAXIVE, including diphtheria toxoid.

 

Before getting CAPVAXIVE, tell your health care provider if you have had an allergic reaction to any vaccine, history of fainting with vaccines, are taking any medications or treatments that might weaken the immune system (like immunosuppressants or steroids), have a weak immune system (which means your body is less able to fight off infections), are pregnant or planning to become pregnant, are breastfeeding or plan to breastfeed.

 

The most common side effects of CAPVAXIVE include pain, redness, or swelling where you got the injection, feeling tired, headache, and muscle aches and fever. These side effects usually last less than 3 days.

 

After getting CAPVAXIVE, tell your health care provider right away about these side effects or any unusual symptoms that develop after you get this vaccine. Get medical care right away if you have symptoms of an allergic reaction, which may include wheezing or trouble breathing, swelling of the face, lips, or tongue, hives, and rash.

 

CAPVAXIVE might not protect everyone who gets the vaccine.

 

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

 

Please read the accompanying Patient Information for CAPVAXIVE and discuss it with your health care provider. The physician Prescribing Information also is available.

 

 

What is CAPVAXIVE® (Pneumococcal 21-valent Conjugate Vaccine)?
Important Safety Information

CAPVAXIVE is a vaccine for individuals 18 years of age and older to help protect against invasive pneumococcal disease and pneumonia caused by certain types of bacteria called pneumococcus.

Important Safety Information

You should not get CAPVAXIVE® (Pneumococcal 21-valent Conjugate Vaccine) if you are allergic to any of the ingredients in CAPVAXIVE, including diphtheria toxoid.

 

Before getting CAPVAXIVE, tell your health care provider if you have had an allergic reaction to any vaccine, history of fainting with vaccines, are taking any medications or treatments that might weaken the immune system (like immunosuppressants or steroids), have a weak immune system (which means your body is less able to fight off infections), are pregnant or planning to become pregnant, are breastfeeding or plan to breastfeed.

 

The most common side effects of CAPVAXIVE include pain, redness, or swelling where you got the injection, feeling tired, headache, and muscle aches and fever. These side effects usually last less than 3 days.

 

After getting CAPVAXIVE, tell your health care provider right away about these side effects or any unusual symptoms that develop after you get this vaccine. Get medical care right away if you have symptoms of an allergic reaction, which may include wheezing or trouble breathing, swelling of the face, lips, or tongue, hives, and rash.

 

CAPVAXIVE might not protect everyone who gets the vaccine.

 

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

 

Please read the accompanying Patient Information for CAPVAXIVE and discuss it with your health care provider. The physician Prescribing Information also is available.