According to the CDC, more than 4,000 children are diagnosed with invasive pneumococcal disease, or IPD, in the United States each year. IPD can manifest as bacteremia, pneumonia and even meningitis. A recent CDC data review shows that children younger than age 5 years continue to develop IPD despite updated pneumococcal vaccination recommendations, prompting the agency to renew its call for appropriate immunization against Streptococcus pneumoniae infection.
A policy statement from the American Academy of Pediatrics(pediatrics.aappublications.org) notes that although the overall prevalence of pneumococcal disease dropped significantly after the introduction of a seven-valent pneumococcal conjugate vaccine, or PCV7, in 2000, other pneumococcal strains not covered by the vaccine have continued to cause disease. Some of these strains, in fact, have become even more prevalent than before PCV7 entered the U.S. market.
In December 2010, the CDC's Advisory Committee on Immunization Practices, or ACIP, recommended(www.cdc.gov) that health care professionals begin using a newly approved 13-valent pneumococcal conjugate vaccine, or PCV13, instead of PCV7, with doses given at ages 2, 4, 6 and 12-15 months. PCV13 is approved for use in children ages 6 weeks to 71 months.
- Approval of a 13-valent pneumococcal conjugate vaccine, or PCV13, last year means that children can be protected from 13 common serotypes of Streptococcus pneumoniae, including the serotypes that now most commonly cause invasive pneumococcal disease.
- The vaccine is recommended for use in children at ages 2, 4, 6 and 12 through 15 months.
- Children ages 14 through 59 months who have completed the full series of the previously recommended seven-valent pneumococcal vaccine should receive a single supplemental dose of PCV13.
The ACIP guidance, which subsequently was approved by the AAFP also included a recommendation that children ages 14 months through 59 months who already had completed the four-dose PCV7 series receive a supplemental dose of PCV13.
According to CDC officials, a recent review of data from the agency's ongoing PCV13 vaccine effectiveness evaluation revealed that dozens of children younger than age 5 years continue to develop IPD. Most of these children had completed the full PCV7 vaccine series but had not received the recommended supplemental dose of PCV13. Moreover, analysis of data from five CDC Immunization Information System sentinel sites show that only 50 percent of children ages 12 months through 23 months have received the supplemental dose of PCV13, and only 25 percent of children ages 2 through 5 years have received the supplemental dose.
Because patients who have received only the PCV7 vaccine remain at risk for IPD caused by serotypes unique to PCV13, the CDC is urging health care professionals to
- review patients' immunization records;
- provide patients ages 14 months through 59 months who have completed the full PCV7 series a supplemental dose of PCV13 at the next scheduled office visit if they have not yet received the new vaccine; and
- use PCV13 rather than PCV7 vaccine, even if office supplies of PCV7 are not yet exhausted.
PCV7 was and PCV13 is manufactured by Wyeth Pharmaceuticals Inc., which now is a subsidiary of Pfizer Inc. Pfizer's current policy allows for the return of PCV7 product in full packages that is within six months of expiry or that is 12 months post-expiry. For more information on returning product for credit, physicians may contact Inmar, which processes PCV7 returns for Pfizer, at (800) 967-5952.
CDC: Pneumococcal Conjugate Vaccine Information Statement(www.cdc.gov)