Pneumococcal Vaccine
Class: Vaccines
ATC Class: J07A1
VA Class: IM100
Brands: Pneumovax 23, Prevnar 13
Introduction
Inactivated (polysaccharide) vaccine. Commercially available in US as pneumococcal 13-valent conjugate vaccine (diphtheria CRM197 protein) (PCV13; Prevnar 13) and pneumococcal vaccine, polyvalent (pneumococcal 23-valent vaccine; PPSV23; Pneumovax 23). Both vaccines contain capsular antigens extracted from Streptococcus pneumoniae and are used to stimulate active immunity to pneumococcal infection. Various other pneumococcal vaccines are being investigated or may be available in other countries.
Uses for Pneumococcal Vaccine
Prevention of Pneumococcal Disease
PCV13 (Prevnar 13): Prevention of invasive disease (e.g., pneumonia, meningitis, bacteremia) caused by Streptococcus pneumoniae in infants 6 weeks through 23 months of age, healthy children 2 through 5 years of age, children and adolescents 6 through 18 years of age at increased risk for pneumococcal disease, adults ≥19 years of age at increased risk for pneumococcal disease†, and adults ≥65 years of age. Provides protection only against the 13 S. pneumoniae serotypes represented in the vaccine (i.e., 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F).
PPSV23 (Pneumovax 23): Prevention of invasive disease (e.g., pneumonia, meningitis, bacteremia) caused by S. pneumoniae in children 2 through 18 years of age at increased risk for pneumococcal disease, adults ≥19 years of age at increased risk for pneumococcal disease, and adults ≥65 years of age. Provides protection only against the 23 S. pneumoniae serotypes represented in the vaccine (i.e., 1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F, 33F).
S. pneumoniae is a major cause of serious or invasive illness and death worldwide. In the US, pneumococcal pneumonia results in an estimated 175,000 hospitalizations each year (case fatality rate 5–7%); there are >50,000 cases of pneumococcal bacteremia (case fatality rate about 20%) and 3000–6000 cases of pneumococcal meningitis (case fatality rate about 30%) reported annually. Case fatality rates are higher in the elderly (60–80% for pneumococcal bacteremia or meningitis in this age group). In children <5 years of age, S. pneumoniae has been a leading cause of bacterial meningitis.
Epidemiology of pneumococcal disease in the US changed substantially after routine infant and childhood vaccination against the disease was initiated in 2000. Overall incidence of invasive pneumococcal disease in children <5 years of age decreased from approximately 99 cases/100,000 population in 1998–1999 to 21 cases/100,000 population in 2008. Routine infant and childhood vaccination against pneumococcal disease also reduced incidence of invasive pneumococcal disease among unvaccinated individuals of all ages. Data from 1998–1999 and 2008 indicate that overall rates of invasive pneumococcal disease in individuals 18–49, 50–64, and ≥65 years of age decreased 34, 14, and 37%, respectively.
PCV13 (Prevnar 13) is the pneumococcal vaccine recommended by the USPHS Advisory Committee on Immunization Practices (ACIP), AAP, and others for routine primary and catch-up vaccination in all infants 2 through 23 months of age and healthy children 2 through 5 years o...
