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pneumococcal vaccines

NACI (National Advisory Committee on Immunization): makes recommendation for the use of vaccines currently or newly approved for use in humans in Canada. Vaccines that have Health Canada approval can still be recommended even if NACI guidelines have not yet been updated to reflect the new option.

Prevnar 13 (PCV13)  

All immunocompromised adults ≥18 years

Can be considered in adults at high risk of IPD due to underlying medical conditions followed by PPSV23

Can be considered on an individual basis for ≥65 years

Vaxneuvance® (PCV15): Pending

Prevnar 20 (PCV20): Pending

Pneumovax23 (PPSV23): All immunocompromised adults ≥18 years

                       Immunocompetent adults 18 to 〈65 years at high-risk

                       All adults ≥65 years 

Pneu-C-13 and Pneu-P-23 dose sequencing, immunocompetent adults ≥65 years of age

[Received   Pneu-P-23 Previously]

↓                                                                                               ↓

Yes                                                                             No

 How long ago?                                                        Pneu-C-13 

      ↓                                              ↓                         ↓ ≥8 weeks

 Less than 1 year ago              At least 1 year ago      Pneu-P-23

      ↓                                                          ↓                                 

 Wait for 1 year since Pneu-P-23 →  Pneu-C-13

CDC (Centers for Disease Control and Prevention) 2022 guidelines for PCV15 and PCV20

CDC recommends routine administration of pneumococcal conjugate vaccine (PCV15 or PCV20) for all adults ≥65 years and adults 19-64 years with underlying medical conditions or other risk factors who have never received any pneumococcal conjugate vaccine or whose previous vaccination history is unknown.

 Vaccination Complete

1. PCV20                                                                                         

2. PCV15 → ≥ 1 year apart (8 weeks can be considered)  → PPSV23

3. If previously received PPSV23 → ≥1 year apart → PCV15 0R PCV20     

Prevnar 20 is indicated for the active immunization of: 

1. Adults 18 years and over

2. Prevention of pneumonia and invasive pneumococcal disease caused by 20        Streptococcus pneumoniae serotypes

Clinical efficacy for the prevention of pneumonia was studied with Prevnar 13 for the shared serotypes, but not for the additional serotypes 8, 10A, 11A, 12F, 15B, 22F, and 33F

Prevnar 20 may not prevent disease caused by S. Pneumonia serotypes that are not contained in the vaccine

 

Question: When should a patient be re-immunized with Pneumococcal-23 vaccine?

Re-Immunization with Polysaccharide 23-Valent Pneumococcal Vaccine (PNEU-P-23)

            National Advisory Committee on Immunization (NACI) April 2022

Age2 years and over with Risk factors for invasive pneumococcal disease (IPD) i.e. 〈65 years

1.  One lifetime booster dose is recommended 5 years after the initial dose for those at highest risk of IPD.

2. For individuals aged 2 years with a condition that places them at highest risk of IPD.

3.  Functional or anatomic asplenia or sickle cell disease

4.  Hepatic cirrhosis

5. Chronic renal failure or nephrotic syndrome

6. HIV infection

7. Immunosuppression related to disease or therapy

Age 65 and older

1.  Regardless of other risk factors, those 65 years and over should receive one dose of Pneu-P-23 as long as 5 years has passed since the previous Pneu-P-23 dose

2.  All individuals at the age of 65 years, regardless of risk factors