* use of immunosuppressants * congenital or acquired immunodeficiency (eg, history of hiv infection, hematological disease, current malignancy, or others) * chronic condition that may significantly interfere with the immune response in the opinion of the investigator * history of covid-19 within 16 weeks before study vaccination * previous pneumococcal vaccination * contraindication against any ingredient of the nvx or the pcv20 vaccine

* use of immunosuppressants * congenital or acquired immunodeficiency (eg, history of hiv infection, hematological disease, current malignancy, or others) * chronic condition that may significantly interfere with the immune response in the opinion of the investigator * history of covid-19 within 16 weeks before study vaccination * previous pneumococcal vaccination * contraindication against any ingredient of the nvx or the pcv20 vaccine

use of immunosuppressants congenital or acquired immunodeficiency (eg, history of hiv infection, hematological disease, current malignancy, or others) chronic condition that may significantly interfere with the immune response in the opinion of the investigator history of covid-19 within 16 weeks before study vaccination previous pneumococcal vaccination contraindication against any ingredient of the nvx or the pcv20 vaccine

use of immunosuppressants congenital or acquired immunodeficiency (eg, history of hiv infection, hematological disease, current malignancy, or others) chronic condition that may significantly interfere with the immune response in the opinion of the investigator history of covid-19 within 16 weeks before study vaccination previous pneumococcal vaccination contraindication against any ingredient of the nvx or the pcv20 vaccine