Prevnar 13 Pneumococcal Vaccine

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Clearing Up Pneumococcal Vaccine Questions

Don Hackett — Sun, 19 Jan 2020 22:48:04 +0000

Reviewer:

Pneumococcal Vaccine Recommendation

A new commentary published in JAMA reinforces the changes by the Centers for Disease and Control (CDC)’s vaccine committee in 2019 regarding pneumococcal vaccine recommendations for seniors.

This news article was written by Bridget M. Kuehn, MSJ, on January 14, 2020, saying the CDC’s Advisory Committee on Immunization Practices (ACIP) suggests that adults aged 65 years or older should receive only the 23-valent pneumococcal polysaccharide vaccine (PPSV23) with a few exceptions.

This ACIP announcement was issued on November 22, 2019, because the pneumococcal vaccination recommendations had undergone several changes, causing confusion for those who need to select a preventive vaccine.

In 2014, the ACIP recommended that older adults receive the 13-valent pneumococcal conjugate vaccine (PCV13) first, then the PPSV23 at least 1 year later.

Since then, widespread childhood vaccination with PCV13 and its predecessor the 7-valent pneumococcal conjugate vaccine have “led to sharp declines in pneumococcal disease among unvaccinated children and adults,” according to the ACIP’s review of the evidence.

Based on that review, the ACIP voted to remove the recommendation for routine use of PCV13, followed by PPSV23 in this senior population.

“Incidence of PCV13-type disease has been reduced to historically low levels among adults aged ≥65 years through indirect effects from pediatric PCV13 use,” the authors wrote.

The PPSV23 vaccine contains 12 serotypes in common with PCV13 and an additional 11 serotypes, for which there are no indirect effects from PCV13 use in children.

But, adults aged 19 years or older with an immunocompromising condition, cerebral spinal fluid leak, or cochlear implant should continue to receive both vaccines, the ACIP recommends.

And, some adults aged 65 years or older may have a greater risk of exposure to strains of Streptococcus pneumoniae covered by the PCV13 vaccine, such as those seniors living in nursing homes or long-term care facilities, people living in areas with low rates of pediatric vaccination with PCV13, or those traveling to areas with no childhood PCV13 vaccination program.

Furthermore, the ACIP recommends that healthcare providers engage in shared decision-making with such at-risk patients to decide whether they should continue to receive PCV13 followed by the PPSV23 vaccination.

“ACIP will continue to review relevant data as they become available and update pneumococcal vaccination policy as appropriate,” the CDC’s authors wrote.

This ACIP recommendation is important since about 175,000 cases of the pneumococcal disease occur each year in the USA. And, the fatality rate is between 5-7 percent, says the CDC.

The pneumococcal disease is spread from person to person by droplets in the air. The pneumococci bacteria are common inhabitants of the human respiratory tract.

There are 2 major clinical syndromes of invasive pneumococcal disease: bacteremia, and meningitis. They are both caused by infection with the same bacteria but have different manifestations.

Pneumococcal pneumonia is the most common disease caused by pneumococcal infection and can occur in combination with bacteremia and/or meningitis, or it can occur alone.

Moreover, there are 3,000-6,000 cases of pneumococcal meningitis each year.

Additionally, new research is helping to clarify the benefits of childhood vaccinations.

A study published on October 15, 2019, found a bacterial infection that can lead to pneumonia or meningitis is also linked to weakened immune systems in children. This study found the rate of immune deficiency in healthy children presenting with the pneumococcal disease was up to 26.4 percent.

To address this issue, the CDC continues to say all infants should be given a primary series of PCV13, at ages 2, 4, and 6 months with a booster at age 12 to 15 months.

The CDC’s recommendation of the PCV13 vaccine, (Prevnar 13) and pneumococcal polysaccharide vaccine (PPSV23, Pneumovax) should not be given at the same visit.

Since these vaccination suggestions have changed and could be confusing, the CDC suggests everyone speak with a healthcare provider to learn which vaccine is best for their needs.

Pneumococcal disease and vaccine news published by Precision Vaccinations.

Sub Title:

PPSV23 pneumococcal vaccination recommendations have undergone several changes

References:

CDC: ACIP Grade for PCV13 use among adults 65 years and older

Weak Immune Systems Linked to Bacterial Infections in Children

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65 and Over

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Emory University Takes Vaccine Development Leadership Role

Don Hackett — Fri, 20 Dec 2019 18:14:05 +0000

Reviewer:

Emory University tapped to lead national infectious disease, vaccine effort

Emory University announced it will lead a new effort aimed at developing vaccines and other therapies to combat infectious diseases.

Announced by the National Institute of Allergy and Infectious Diseases (NIAID) on December 19, 2019, Emory is leading 7 other academic institutions that will form the new Infectious Diseases (ID) Clinical Research Consortium Leadership Group.

The other institutions represented on the ID leadership group are Baylor College of Medicine; John Hopkins University; University of Alabama Birmingham; the University of Cincinnati (and Cincinnati Children’s); the University of Maryland, Baltimore; the University of Washington; and Vanderbilt University.

This announcement says David S. Stephens, M.D., professor and chair of the Department of Medicine in Emory University School of Medicine and vice president for research of Emory’s Woodruff Health Sciences Center, will serve as the ID leadership group’s principal investigator along with Kathleen Neuzil, M.D., professor of medicine and pediatrics at the University of Maryland.

Additionally, part of the National Institutes of Health (NIH), NIAID intends to provide approximately $29 million per year over 7 years for nine Vaccine and Treatment Evaluation Units (VTEUs) around the country and the companion leadership group.

For more than half a century, NIAID has supported the VTEUs which have performed high-quality clinical research to test new vaccines and therapies for infectious diseases in adults and children.

An important strength of the VTEUs is their ability to enroll large numbers of volunteers into trials rapidly and vaccinate them in a safe, effective and quick manner. This rapid-response capability is especially important for testing vaccines designed to counteract emerging public health concerns says the NIAID website.

The other 8 VTEU sites are Baylor College of Medicine; Cincinnati Children’s Hospital Medical Center; Kaiser Permanente Washington Health Research Institute; Saint Louis University; University of Maryland School of Medicine; University of Rochester; University of Washington; and Vanderbilt University Medical Center.

Moving forward, these VTEUs will work with the new leadership group to enhance integration, efficiency, and collaboration in order to address NIAID priorities.

NIAID Director Anthony S. Fauci, M.D., said in a related press release, “This flagship program aligns with NIAID’s dual mission of conducting robust, wide-ranging biomedical research on existing infectious diseases while maintaining readiness to respond to emergent disease threats with the quick design and launch of clinical trials. We anticipate that the addition of a centralized leadership group will further enhance the effectiveness of this time-tested program.”

One of the primary goals of NIAID research is to develop new vaccines against infectious diseases, such as pneumococcal infections.

The World Health Organization estimates that more than 1.6 million people, including more than 800,000 children under five, die each year from pneumococcal infections.

NIAID has invested more than 30 years of research into developing pneumococcal vaccines.

Early product development support, as well as Phase I and II studies conducted by VTEU sites in infants, were helpful in developing Prevnar, a vaccine to prevent pneumococcal diseases in children younger than 2 years of age.

VTEUs also test new ways to deliver vaccines.

For example, VTEUs enrolled young children in a Phase III trial of FluMist, an influenza vaccine administered by nasal spray. The vaccine was 93 percent effective against the predominant flu strains of the 1996-97 flu season.

In 1998, researchers inoculated the children against three flu strains thought to be circulating that season. The nasal spray vaccine was 86 percent effective against not only the flu strains covered in the vaccine but also against a circulating strain not included in the injected form of the vaccine.

Furthermore, to respond to public health emergencies, the leadership group will have the capacity to rapidly organize and initiate clinical trials at the VTEU sites.

The grant number for the leadership group award is 1 UM1 AI148684-01.

Vaccine Research news published by Precision Vaccinations

Sub Title:

Infectious Diseases Clinical Research Consortium to test new vaccines and therapies

References:

NIH: Network of VTEU Sites

Infectious Diseases Clinical Research Consortium awards announced

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Vaccine reduces likelihood of severe pneumonia

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World Pneumonia Day Celebrates Vaccines That Save Children

Danielle Reiter RN — Tue, 12 Nov 2019 19:05:07 +0000

Reviewer:

Holly Lutmer PharmD

In tandem with World Pneumonia Day, a new study has found severe pneumonia can decrease by 35 percent in children who receive a vaccine against a pneumonia-causing bacteria.

World Pneumonia Day is marked every year on November 12th to increase global awareness that pneumonia is one of the leading causes of deaths in children under 5-years old, despite being easily preventable.

This new research published on November 11, 2019, shows pneumonia is the most common reason why children are admitted to the hospital in Laos, with most requiring treatment with oxygen, especially young infants.

The study found 1 in 5 hospital admissions for children under 5-years of age in Laos is due to pneumonia.

The findings are a collaborative effort between the Murdoch Children's Research Institute (MCRI) and the University of Melbourne along with colleagues in the Asia-Pacific region.

MCRI Professor Fiona Russell, Ph.D., said in this press release ‘because showing the impact of the vaccine against pneumonia was challenging as surveillance systems weren't in place, her team had to think of a new way to illustrate how the vaccine worked.’

Laos was the first country in South-East Asia to introduce the pneumococcal conjugate vaccine (PCV13) into its national immunization program in 2013, which protects against the 13 most common types of pneumococcus.

"Vaccinating children protects the whole community by reducing the spread of pneumococcus because little children who commonly carry pneumococcus in the back of their nose are mostly responsible for the spread of these bacteria," Dr. Russell said.

"While most children with pneumococcus in their nose remain free of symptoms, a small but important proportion of children will have bacteria that spread into the lungs or bloodstream, causing serious infection and possibly death.

"By discovering that the bacteria are commonly carried at the back of the nose, our study highlights that it is likely a significant contributor to severe infections in Laos."

Dr. Russell said ‘the research was among the first to evaluate pneumococcal vaccines in Asia, as pneumococcus was often overlooked as a cause of pneumonia because it is challenging to detect.’

"One of the main causes of death from pneumonia is a lack of oxygen in the blood. Supplementary oxygen is a life-saving therapy that is unfortunately not consistently available across hospitals in Laos," she said.

Professor Russell said her team had developed a new method using data collected from a hospital in Laos, to demonstrate that the vaccine worked against the severest form of pneumonia.

Every year more than 800,000 people die from pneumonia worldwide, but the highest burden of disease is in low-to-middle income countries such as Laos.

‘Although vaccines and other preventative efforts are decreasing the burden of the disease, much more work is still required. Those living in poor communities are at the highest risk of pneumonia.’

‘Every child, regardless of where they are born, deserves access to lifesaving vaccines and medicines,’ says the World Health Organization (WHO).

The US Centers for Disease Control and Prevention (CDC) recommends pneumococcal vaccination for all children younger than 2 years old and all adults 65 years or older. In certain situations, other children and adults should also get pneumococcal vaccines.

There are two kinds of vaccines that help prevent pneumococcal disease.

CDC recommends vaccination with the pneumococcal conjugate vaccine (PCV13 or Prevnar 13®) for:

All children younger than 2 years old
All adults 65 years or older
People 2 through 64 years old with certain medical conditions

CDC recommends vaccination with the pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax23®) for:

All adults 65 years or older
People 2 through 64 years old with certain medical conditions
Adults 19 through 64 years old who smoke cigarettes

Because of age or health conditions, some people should not get certain vaccines and should speak with a healthcare professional for more information.

These researchers collaborated with the Laos National Immunization Program Ministry of Health, Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, the University of Health Sciences, and the WHO.

Funding was provided by Murdoch Children's Research Institute, WHO, National Health and Medical Research Council, Gavi, Vaccine Alliance, and the Bill and Melinda Gates Foundation.

World Pneumonia Day news is published by Vax-Before-Travel

Sub Title:

Vaccinating children with PCV 13 protects communities by reducing the spread of pneumococcus

References:

WHO: World Pneumonia Day

CDC: Pneumococcal Vaccination: What Everyone Should Know

WHO: Impact of the change in WHO’s severe pneumonia case definition on hospitalized pneumonia epidemiology

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prevnar- 13

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Weak Immune Systems Linked to Bacterial Infections in Children

Don Hackett — Tue, 15 Oct 2019 17:29:49 +0000

Reviewer:

Prevalence of Immunodeficiency in Children With Invasive Pneumococcal Disease in the Pneumococcal Vaccine Era

A new study has found a bacterial infection that can lead to pneumonia or meningitis is linked to weakened immune systems in children.

This study found the rate of immune deficiency in healthy children presenting with pneumococcal disease was up to 26.4 percent.

The new research published on September 30, 2019, in JAMA Pediatrics, is important news since pneumococcal disease causes around 11 percent of children aged under 5 fatalities annually.

These researchers say ‘invasive pneumococcal disease, especially more than 1 episode, could be an important marker of a child having an immune deficiency.’

And, to improve early identification of an immune deficiency and prevent further infections, a better understanding of the risk factors for pneumococcal disease is needed.

Various studies have shown that almost 70 percent of children with an immune deficiency had 2 or more bouts of invasive pneumococcal disease.

This was the first study since the widespread availability of pneumococcal vaccine.

"Even with optimal vaccine coverage, this research shows there is a group of children who are vulnerable to this life-threatening bacterial infection," study senior author Dr. Amanda Gwee, from the Murdoch Children's Research Institute, said in an October 14, 2019, press release.

Pneumococcal disease, where bacteria infects a major organ or a person's blood, can lead to serious health problems such as sepsis, pneumonia, meningitis and bloodstream infections.

Lead author Dr. Coen Butters, from The Royal Children's Hospital, says children over two years of age who present with pneumococcal disease should have testing of their immune system.

"There are no guidelines for immune evaluation of these children, which results in significant variation in practice," Dr. Butter says.

"There is a risk that these children could be missed, resulting in delayed diagnosis, delayed access to specialist services and more stress for families."

"Early testing enables us to ensure a healthy immune system and where required, offer education and treatment to reduce the very real risk of recurrent infections and death."

Related Pneumococcal disease news

The study is the first to systematically examine results from 17 studies of 6,022 children, under the age of 18, worldwide.

Dr. Butters says the study will inform current clinical guidelines and form the basis for further clinical studies in this area. He says further studies looking at the predisposing factors for invasive pneumococcal disease in the era of pneumococcal immunization are required.

The US Centers for Disease Control and Prevention (CDC) says vaccines help prevent pneumococcal disease, which is any type of infection caused by Streptococcus pneumoniae bacteria.

There are 2 kinds of pneumococcal vaccines available in the United States:

Pneumococcal conjugate vaccine
Pneumococcal polysaccharide vaccine

The CDC recommends the pneumococcal polysaccharide vaccine for all adults 65 years or older, people 2 through 64 years old with certain medical conditions, and adults 19 through 64 years old who smoke cigarettes.

No researcher conflicts of interest were disclosed.

Pneumococcal vaccine news published by Precision Vaccinations

Sub Title:

Immune system evaluations may be needed for children older than 2 years presenting with invasive pneumococcal disease

References:

NIHR: Looking deeper: invasive pneumococcal disease and incidence of immune deficiency

Weak immune system linked to serious bacterial infection in children

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American Lung Association Supports National Immunization Awareness Month

Don Hackett — Wed, 07 Aug 2019 23:11:36 +0000

Reviewer:

National Immunization Awareness Month Highlights the Need for Vaccination

During National Immunization Awareness Month in August 2019, the American Lung Association (ALA) is reminding adults of potentially serious lung diseases, such as influenza and pneumococcal pneumonia.

In a press release on August 7, 2019, the ALA says ‘as a preventive healthcare measure, vaccines work by teaching the body's immune system to recognize and defend against harmful viruses or bacteria before getting an infection and reduce the chance of getting certain infectious diseases.’

According to the Centers for Disease Control and Prevention (CDC), most vaccine-preventable diseases are spread from person to person.

This means that if one person in a community gets an infectious disease, they can spread it to others.

Different than a bad cold, influenza and pneumococcal pneumonia are potentially serious infectious diseases that may be prevented by vaccines, says the ALA.

Pneumococcal Pneumonia:

the most common type of bacterial pneumonia is often spread through coughing. The symptoms of pneumococcal pneumonia can come quickly and may include high fever, excessive sweating and shaking chills, coughing, difficulty breathing, shortness of breath, and chest pain.
The best way to prevent pneumococcal disease is to get the vaccine(s). Pneumococcal vaccines help protect against some of the more than 90 types of pneumococcal bacteria. The pneumococcal conjugate vaccine Prevnar 13, protects against the 13 types of pneumococcal bacteria that cause most of the severe illness in children and adults.

Influenza:

commonly known as the flu, is a highly contagious virus that is usually spread through coughing or sneezing. Symptoms can impact the entire body and may include fever, headache, muscle aches, a dry cough, sore throat, and nasal congestion.
The CDC says there are many different flu viruses and they are constantly changing. The composition of flu vaccines is reviewed annually and updated as needed to match circulating flu viruses. Flu vaccines protect against the 3 or 4 viruses that research suggests will be most common.

"Older adults and those with weakened immune systems or certain chronic health conditions—like asthma or chronic obstructive pulmonary disease (COPD)—are especially vulnerable to infectious disease," said Albert Rizzo, MD, Chief Medical Officer for the American Lung Association.

"In fact, for adults 65 and older living with COPD, the risk for contracting pneumococcal pneumonia is 7.7 times higher than their healthy counterparts, and those with asthma are at 5.9 times greater risk."

The work of the American Lung Association is focused on 4 strategic imperatives:

to defeat lung cancer,
to improve the air we breathe,
to reduce the burden of lung disease on individuals and their families, and
to eliminate tobacco use and tobacco-related diseases.

The American Lung Association, in partnership with Pfizer, is urging adults to talk with their healthcare provider about pneumococcal and influenza vaccinations during August 2019.

For more information, visit Pneumococcal Pneumonia and Influenza, or call the American Lung Association's Lung HelpLine at 1-800-LUNGUSA.

The American Lung Association is the leading organization working to save lives by improving lung health and preventing lung disease, through research, education, and advocacy.

Sub Title:

Pneumococcal pneumonia and influenza are vaccine preventable inflections diseases

References:

CDC: Pneumococcal Disease Symtoms and Complications

CDC: Influenza (Flu) Frequently Asked Flu Questions: 2019-2020 Influenza Season

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Prevnar 13

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Pneumococcal Vaccination Modified Guidelines For Seniors

Don Hackett — Thu, 27 Jun 2019 14:21:12 +0000

Reviewer:

RECOMMENDATION FOR ROUTINE USE OF PREVNAR 13 FOR THE PREVENTION OF PNEUMOCOCCAL DISEASE FOR ADULTS 65 YEARS OR OLDER

The Advisory Committee on Immunization Practices (ACIP) voted to revise the pneumococcal vaccination guidelines and recommend Prevnar 13 for adults aged 65 and older based, on the shared clinical decision making of the provider and patient.

The ACIP, which is the vaccine committee of the Centers for Disease Control and Prevention (CDC), vote on June 26, 2019, means the decision to vaccinate should be made between healthcare providers and their patients.

In 2014, the ACIP voted to recommend Prevnar 13, a pneumococcal 13-valent Conjugate Vaccine, for adults 65 years or older.

“This revised recommendation reinforces direct vaccination remains the best available tool to help prevent against pneumococcal disease,” said Luis Jodar, Pfizer Vaccines, Chief Medical, and Scientific Affairs Officer.

“And the revised recommendation emphasizes the importance of the health care professional and patient relationship in shared decision making regarding vaccination, said Dr. Jodar, in a Pfizer press release.

Previously, Prevnar 13 was recommended by the ACIP in 2012 for adults 19 years of age and older with immunocompromising conditions, such as HIV, chronic renal failure, cancer, functional or anatomic asplenia, cerebral spinal fluid leak, and Cochlear implants.

Recent pneumococcal vaccine news:

The US Centers for Disease Control and Prevention (CDC) says vaccines help prevent pneumococcal disease, which is any type of infection caused by Streptococcus pneumoniae bacteria.

There are 2 kinds of pneumococcal vaccines available in the United States:

Pneumococcal conjugate vaccine
Pneumococcal polysaccharide vaccine

IMPORTANT SAFETY INFORMATION FOR PREVNAR 13:

Severe allergic reaction (e.g., anaphylaxis) to any component of Prevnar 13®or any diphtheria toxoid-containing vaccine is a contraindication
Immunocompromised individuals or individuals with impaired immune responsiveness due to the use of immunosuppressive therapy may have reduced antibody response
In adults, the most common side effects were a pain, redness, and swelling at the injection site, limitation of arm movement, fatigue, headache, muscle pain, joint pain, decreased appetite, vomiting, fever, chills, and rash
Apnea following intramuscular vaccination has been observed in some infants born prematurely. Vaccination of premature infants should be based on the infant's medical status, and the potential benefits and risks
In infants and toddlers, the most commonly reported serious adverse events were bronchiolitis (0.9%), gastroenteritis (0.9%), and pneumonia (0.9%)
In children, 6 weeks through 17 years, the most commonly reported solicited adverse reactions were injection site tenderness, redness, or swelling, irritability, decreased appetite, decreased or increased sleep, and fever.

The Prevnar 13 vaccine does not protect against diseases caused by S. pneumoniae serotypes that are not in the vaccine.

Relevant Links: CDC vaccination schedules, CDC vaccine price list,international travel alerts, and report vaccine side effects.

Sub Title:

Pfizer Prevnar 13 is a pneumococcal 13-valent Conjugate Vaccine

References:

CDC: Pneumococcal Vaccination

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65 and Over

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621 Bacteria Strains Cause Pneumonia Around the World

Don Hackett — Mon, 10 Jun 2019 19:32:31 +0000

Reviewer:

Pneumococcal lineages associated with serotype replacement and antibiotic resistance in childhood invasive pneumococcal disease

Pneumococcal conjugate vaccines (PCVs) have been focused on the 13 pneumococcal serotypes that account for most of the diseases in infants.

And vaccines such as Prevnar13 have substantially reduced the global burden of invasive pneumococcal disease.

Pneumococcal infections can range from ear and sinus infections to pneumonia and bloodstream infections. Children younger than 2 years old and adults 65 years or older are among those most at risk for disease, says the Centers for Disease Control and Prevention.

Despite the success of PCVs, the invasive pneumococcal disease remains an important health priority owing to an increase in the incidence of disease caused by non-vaccine serotypes.

This event is known as ‘serotype replacement.’

Serotype replacement has been reported by several countries, but not the USA.

According to a new study published in The Lancet on June 10, 2019, various studies characterizing serotype replacement in cases of the invasive pneumococcal disease have primarily focused on changes in serotypes.

Two mechanisms of serotype replacement have been suggested.

The first is the expansion of non-vaccine-type lineages to partly fill the niche vacated by vaccine-type lineages.

The second is a within-lineage expansion of non-vaccine serotypes, which can be explained as a concomitant increase in non-vaccine serotypes and decrease in vaccine serotypes within a lineage after PCV introduction, usually through the expansion of existing non-vaccine-type components rather than contemporaneous capsular switching.

Multiple serotypes (vaccine and non-vaccine) expressed by a single pneumococcal lineage were not unusual because pneumococci are able to replace capsular biosynthesis genes through the acquisition of foreign DNA by natural genetic transformation.

The Global Pneumococcal Sequencing (GPS) project was set up to guide the design of preventive measures for pneumococcal diseases beyond PCV13 by defining pneumococcal lineages across a global pneumococcal population and attempting to capture how lineages evade vaccines.

As part of the GPS project, a high-resolution population structure of 621 Global Pneumococcal Sequence Clusters (GPSCs) was defined by analyzing 20,027 pneumococci genomes.

In this study, the researchers aimed to identify the predominant serotypes causing invasive pneumococcal disease among children younger than 3 years and their associated lineages after the introduction of PCV13 in six countries, investigate the mechanisms of serotype replacement in disease, and identify international lineages contributing to post-PCV13 invasive pneumococcal disease and report their antibiotic-resistant traits.

This study found 5 most prevalent serotypes in the PCV13 period varied between countries, with only serotypes 5, 12F, 15B/C, 19A, 33F, and 35B/D common to 2 or more countries.

These serotypes were associated with more than 1 lineage, except for serotype 5 (GPSC8).

Serotype replacement was mainly mediated by the expansion of non-vaccine serotypes within vaccine-type GPSCs and, to a lesser extent, by increases in non-vaccine-type GPSCs.

A globally spreading lineage, GPSC3, expressing invasive serotypes 8 in South Africa and 33F in the USA and Israel, was the most common lineage causing non-vaccine serotype invasive pneumococcal disease in the PCV13 period.

We observed that same prevalent non-vaccine serotypes could be associated with distinctive lineages in different countries, which exhibited dissimilar antibiotic resistance profiles.

In total, these scientists discovered 621 bacteria strains that cause pneumonia across more than 50 countries.

This study concluded saying, ‘the continued genomic surveillance of the dynamics of the pneumococcal population with increased geographical representation in the post-vaccine period will generate further knowledge for optimizing future vaccine design.’

Recent PCV vaccine news:

The funding for this study was from the Bill & Melinda Gates Foundation, Wellcome Sanger Institute, and the US Centers for Disease Control.

No conflicts of interest were disclosed.

Sub Title:

PCV13 vaccines prevent Streptococcus pneumoniae which is the most common cause of bacterial pneumonia

References:

International genomic definition of pneumococcal lineages, to contextualise disease, antibiotic resistance and vaccine impact

Pneumococcal Disease

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UK Decreases Prevnar 13 Vaccinations From 3 to 2 Doses for Infants

Don Hackett — Wed, 17 Apr 2019 12:49:25 +0000

Reviewer:

John Paul Sanchez, PharmD

The United Kingdom (UK) announced it will become the first country in the world to reduce the pneumococcal conjugate vaccine (PCV) from 3 to 2 doses for children.

The PCV vaccine, Prevnar 13, which protects children from 13 types of pneumococcal bacteria and against diseases such as pneumonia, sepsis, and some types of meningitis, is currently given to infants at 2 and 4 months of age, followed by a booster at 13 months.

This decision is based upon the July 2018 Joint Committee on Vaccination and Immunisation (JCVI) recommendation after a study published in the Lancet showed that the PCV vaccine was just as effective and safe in children when given in 2 shots, reported The Telegraph on April 16, 2019.

A UK Department of Health and Social Care spokesperson said it was estimated that the vaccine had prevented more than 5,000 deaths and 40,000 cases of the serious disease since it was first introduced.

"The program has been so effective in creating population-wide immunity in the UK that independent experts have advised we can sustain the excellent results we have seen already by moving from three doses of the vaccine to two," the UK spokesperson added.

Experts believe that the change could eventually pave the way for similar policies in lower and middle-income countries, saving them significant amounts of money.

The UK does not disclose how much it pays for Prevnar 13, which is manufactured by the US drug firm Pfizer. But it is one of the most expensive vaccinations in the routine childhood schedule and in the US it costs $130 for every shot.

David Goldblatt, professor of vaccinology and immunology at University College, London, who led the research that helped inform the JCVI's decision, said that the UK's decision would give confidence to other countries.

"If you're a country which has only recently introduced the Prevnar 13 vaccine you couldn't go straight to the [new dosing] schedule. But there are some countries in Africa - South Africa is one example - which could move to it relatively quickly," he said.

Recent Prevnar 13 news articles:

In the USA, the Centers for Disease Control and Prevention (CDC) recommends the pneumococcal conjugate vaccine for all children younger than 2 years old, all adults 65 years or older, and people 2 through 64 years old with certain medical conditions.

The CDC recommends pneumococcal polysaccharide vaccine for all adults 65 years or older, people 2 through 64 years old with certain medical conditions, and adults 19 through 64 years old who smoke cigarettes.

Talk with your child’s healthcare professional if you have questions about vaccines.

Relevant Links: CDC vaccination schedules, CDC vaccine price list, international travel alerts, and report vaccine side effects.

Sub Title:

CDC recommends pneumococcal conjugate vaccine (PCV) for all children younger than 2 years old

References:

World watches as UK announces it will drop key childhood vaccine to two doses

JOINT COMMITTEE ON VACCINATION AND IMMUNISATION PNEUMOCOCCAL SUB-COMMITTEE

Pneumococcal conjugate vaccine 13 delivered as one primary and one booster dose compared with two primary doses and a booster

Pneumococcal Vaccination

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Switching to PCV13 Delivered Positive Benefits

Don Hackett — Mon, 29 Oct 2018 18:01:48 +0000

Reviewer:

Decline in Pneumococcal Disease Attenuated in Older Adults and Those With Comorbidities Following Universal Childhood PCV13

The switch from the 7-valent pneumococcal conjugate vaccine (PCV7) to the 13-valent pneumococcal conjugate vaccine (PCV13) in children was associated with major declines in pneumococcal disease later in life as adults, according to research published in Clinical Infectious Diseases.

Most importantly, this new study reported from the pre- to post-PCV13 period, invasive pneumococcal diseases (IPD) rates declined 5 percent.

Additionally, all-cause hospitalized pneumonia (ACHP) rates declined 4 percent across age and risk groups, these researchers wrote.

These researchers used a retrospective design and 2 large healthcare claims repositories to evaluate changes in rates of IPD among US adults, to better understand the impact of the switch to the PCV13 vaccine.

This analysis was limited to hospitalized patients with pneumonia to focus attention on cases that are more likely due to pneumococcal disease.

Despite recommendations for PCV13 immunization in adults with immunocompromising conditions beginning in 2012, the uptake in senior adults was still relatively small by the end of our study period, which was December 2015.

This data supports the Centers for Medicare and Medicaid Services, which reported that only 22.9 percent of senior adults had received PCV13 by 2015.

‘In summary, the findings of this large observational study suggest that the switch to PCV13 was associated with large declines in IPD among all US adults irrespective of age and risk profile and with substantial decreases in ACHP in US adults except those over 75 years of age.’

‘In the long term, we need new strategies such as expanded valency vaccines or modulation of the chronic inflammatory state associated with chronic disease and aging. In the short term, pneumococcal and influenza vaccinations are recommended for prevention, and uptake of both is below recommended levels for adults,’ said these researchers.

An estimated 30,400 cases and 3,690 deaths from invasive pneumococcal diseases (IPD-bacteremia and -meningitis) occurred in the United States in 2016, reported the Centers for Disease Control and Prevention (CDC).

Pneumococcal disease is caused by Streptococcus pneumoniae, a bacterium that has more than 90 serotypes, says Immunize.org.

Most serotypes cause disease, but only a few produce the majority of invasive pneumococcal disease. The 10 most common serotypes cause 62 percent of invasive disease worldwide.

It can cause ear infections, and it can also lead to more serious infections of the:

Lungs (pneumonia)
Blood (bacteremia)
Covering of the brain and spinal cord (meningitis)

Most private health insurance policies cover pneumococcal vaccines and Medicare Part B also covers 100 percent of the cost for both pneumococcal vaccines.

Vaccine discount information can be found here.

Vaccines, like any medicine, can have side effects, says the CDC. You are encouraged to report negative side effects of vaccines to the FDA or CDC.

These researchers did not disclose any conflicts of interest.

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13-valent pneumococcal conjugate vaccine (PCV13) was associated with major declines in pneumococcal disease later in life

References:

Impact of the 13-Valent Pneumococcal Conjugate Vaccine on Pneumococcal Carriage Among American Indians

Switch in a childhood pneumococcal vaccination programme from PCV13 to PCV10: a defendable approach?

Pneumococcal Vaccination: What Everyone Should Know

PCV13 Vaccine Found 70% Effective Against CAP Hospitalizations in Seniors

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PCV10 Vaccine Reduced Inner-Ear Infections by 22%

Don Hackett — Wed, 09 May 2018 19:53:54 +0000

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Reduction in All-Cause Acute Otitis Media in Children <3 Years of Age in Primary Care Following Vaccination

Infants with ‘inner-ear’ infections may have a new solution to resolve this painful issue.

New research is reporting the 10-valent pneumococcal conjugate vaccine (PHiD-CV10) reduced the frequency of acute otitis media (AOM) cases in children by 22 percent.

This reduction was achieved because the PHiD-CV10 vaccine was found to decrease the frequency of the first 2 episodes of AOM.

Additionally, this ‘observational’ study reported a 40 percent decrease in the number of AOM cases in children too young to be vaccinated.

This observation suggests a ‘herd effect’ benefit of this immunization.

Pneumococcal vaccines help protect against some of the more than 90 serotypes of pneumococcal bacteria, which contributes to AOM.

This study of PCV10 usage in Iceland focused on AOM in children younger than 3 years of age. In total, 53,150 children were included and 58,794 AOM episodes.

Acute otitis media is a painful type of ear infection which occurs when the area behind the eardrum becomes inflamed and infected. It occurs when an infant’s eustachian tube traps fluid in the middle ear.

In young children, the eustachian tube is shorter and more horizontal than it is in older children and adults. This makes it more likely to become infected.

In the USA, there are more than 5 million annual cases of children with ear infections. The majority of AOM infections resolve without antibiotic treatment.

But, ear infections remain the most common reason young children are prescribed antibiotics.

There are two types of pneumococcal vaccines: conjugate vaccines and polysaccharide vaccines.

Pneumococcal conjugate vaccine PCV10 differs from PCV7 and PCV13 in the number of serotypes, and in the concentration of the capsular polysaccharides, immunogenicity, carrier proteins, and conjugation process.

Currently, the Centers for Disease Control and Prevention (CDC) recommends vaccination with the pneumococcal conjugate vaccine 13 (PCV13) for:

All babies and children younger than 2 years old
All adults 65 years or older
People 2 through 64 years old who are at increased risk for disease due to certain medical conditions.

The CDC Vaccine Price Lists provides private sector vaccine prices for general information.

Vaccines, like any medicine, can have side effects, says the CDC. You are encouraged to report negative side effects of vaccines to the FDA or CDC.

Sub Title:

PHiD-CV10 vaccine was found to decrease the frequency of the first 2 episodes of acute otitis media

References:

The history of pneumococcal conjugate vaccine development: dose selection

Eustachian Tube Dysfunction

Nasopharyngeal Pneumococcal Carriage after Combined Pneumococcal Conjugate and Polysaccharide Vaccination in Children

Protective Efficacy of a Second Pneumococcal Conjugate Vaccine against Pneumococcal Acute Otitis Media in Infants and Children

Vaccination with 10-valent pneumococcal conjugate vaccine in infants according to HIV status

Pneumococcal Conjugate Vaccines May Reduce Children Ear Infections

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How Can Pneumococcal Immunization Improve?

Don Hackett — Wed, 03 Jan 2018 14:32:15 +0000

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Vaccination Rates in Patients With Medical Indications for the Pneumococcal Polysaccharide Vaccine in a Family Medicine Clinic

A recent study focused on patients who should have received the pneumococcal immunization but had not.

The rates of non-vaccination were 29.8 percent in patients with diabetes, 58.7 percent in patients with asthma, and 62.5 percent in patients who smoke cigarettes.

This study indicated that primary care providers often fail to encourage vaccination against pneumococcus in patients who had asthma or were active smokers.

These researchers identified 3 reasons why patients were not vaccinated:

The care provider did not recommend vaccination during a visit,
The second common reason was ‘refusal by the patient’,
Misclassified patients who had definite medical indications for pneumococcal vaccine, but considered as “low risk.”

The study also reported that physician assistants were less likely than medical residents or medical faculty to vaccinate patients deemed eligible.

But, pharmacists embedded in the family practice clinics were most likely to vaccinate patients. Pharmacists who participated in the study were able to spend more time with patients as they manage chronic conditions.

Each year in the United States, pneumococcal disease kills thousands of adults, including 16,000 adults 65 years or older.

While most people have heard of pneumonia, which is an infection of the lungs. Pneumococcus is one of the most common causes of severe pneumonia.

Pneumococcal disease is an infection caused by Streptococcus pneumoniae bacteria, sometimes referred to as pneumococcus. Pneumococcus can cause many types of illnesses, including ear infections and meningitis, reports the Centers for Disease Control and Prevention (CDC).

The best way to prevent pneumococcal disease is to get the vaccine(s).

Pneumococcal vaccines help protect against some of the more than 90 types of pneumococcal bacteria.

The pneumococcal conjugate vaccine (PCV13 or Prevnar 13) protects against the 13 types of pneumococcal bacteria that cause most of the severe illness in children and adults.

The PCV13 vaccine can also help prevent some ear infections. CDC recommends PCV13 for all children at 2, 4, 6, and 12 to 15 months old. CDC also recommends PCV13 for adults 19 years or older with certain medical conditions and for all adults 65 years or older.

The pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax 23) protects against 23 types of pneumococcal bacteria.

The CDC recommends this vaccine for all adults 65 years or older. It is also recommended for children and adults 2 through 64 years old who are at increased risk for pneumococcal disease.

Because there are more than 90 known pneumococcal serotypes (strains or types) that cause disease, a previous pneumococcal infection will not protect you from future infection.

Therefore, CDC still recommends pneumococcal vaccines for children and adults who have had pneumococcal disease in the past.

Most private health insurance policies cover pneumococcal vaccines. Medicare Part B also covers 100 percent of the cost for both pneumococcal vaccines.

The CDC Vaccine Price List provides private sector vaccine prices for general information. Vaccine discount information in the USA can be found here.

Vaccines, like any medicine, can have side effects, says the CDC. You are encouraged to report negative side effects of vaccines to the FDA or CDC.

These researchers did not disclose any conflicts of interest: Anthony Trovato, PharmD, Karen Gunning, PharmD, BCPS, BCACP, Karly Pippitt, MD, FAAFP. Corresponding Author: Anthony Trovato, University of Utah Health, anthony.trovato@pharm.utah.edu

Sub Title:

Pneumovax 23 and Prevnar 13 vaccines help prevent pneumococcal disease

References:

Pneumococcal

Pneumococcal Disease

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Pneumococcal Vaccination 1p + 1 Schedule Could Save $1.5 Billion

Don Hackett — Mon, 27 Nov 2017 18:00:31 +0000

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