Summary of National Advisory Committee on Immunization statement of March 2023: Interim guidance on the use of pneumococcal 15-valent conjugate vaccine (PNEU-C-15) in pediatric populations

Published: March 21, 2023

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• Overview
• What you need to know

Overview

In July 2022, Health Canada authorized the use of Vaxneuvance^® (PNEU-C-15) in children and adolescents 6 weeks to 17 years of age. Vaxneuvance^®, a new pneumococcal vaccine, was first authorized by Health Canada in November 2021 for use in adults 18 years of age and older for the prevention of invasive disease caused by Streptococcus pneumoniae serotypes.

On March 21, 2023, the Public Health Agency of Canada (PHAC) released interim guidance from the National Advisory Committee on Immunization (NACI) on the use of Vaxneuvance^® in children. This guidance is based on current evidence and NACI expert opinion.

Pneumococcal infections can range from ear and sinus infections, to pneumonia, to more serious infections called invasive pneumococcal disease (IPD).

The most effective way to prevent pneumococcal infections is through immunization. For many years, children have been recommended to receive Prevnar^®13 (PNEU-C-13).

After reviewing the safety and immune responses generated by Vaxneuvance^®:

• NACI recommends that Vaxneuvance^® may be used interchangeably with Prevnar^®13 in children less than 18 years of age. A pneumococcal vaccine series may be started or completed with either vaccine. (Discretionary NACI recommendation)

For the full statement, including supporting evidence and rationale, please see NACI Statement: Interim guidance on the use of pneumococcal 15-valent conjugate vaccine (PNEU-C-15) in pediatric populations.

For more information on NACI's recommendations on the use of pneumococcal vaccines in children, please see the pneumococcal vaccine chapter in the Canadian Immunization Guide (CIG).

What you need to know

NACI reviewed evidence on the safety and immune responses generated by Vaxneuvance^® to develop interim guidance on its interchangeability with Prevnar^®13 in immunization programs for children. NACI has previously issued updated guidance on the use of pneumococcal vaccines in adults.

Pneumococcal disease is the name for any infection caused by the Streptococcus pneumoniae bacteria. Pneumococcal infections can range from ear and sinus infections, to pneumonia, to more serious conditions called invasive pneumococcal disease (IPD). IPD is a severe form of infection that occurs when the bacteria enters the bloodstream (called sepsis) or the central nervous system (called meningitis).

IPD is most common in the very young, the elderly, and people at high risk due to underlying medical conditions or lifestyle factors. For more information on medical conditions that place people at high risk of IPD, please see the pneumococcal vaccine chapter in the Canadian Immunization Guide.

Available evidence suggests that Vaxneuvance^® has a comparable safety profile to Prevnar^®13 and generates comparable immune responses. As such, Vaxneuvance^® may be used interchangeably with Prevnar^®13 in children 6 weeks to 17 years of age.

There are different serotypes of the Streptococcus pneumoniae bacteria. Prevnar^®13 provides protection against 13 serotypes, while Vaxneuvance^® provides protection against 15 serotypes. Vaxneuvance^® has the potential to prevent more cases of IPD in very young children because it protects against two additional serotypes. In the coming year, NACI will further review the relative benefits of each vaccine and provide additional advice.

Vaxneuvance^® can be administered at the same time as, or any time before or after, other routine childhood vaccines.

NACI will continue to monitor the evolving evidence on pediatric pneumococcal vaccines and will update recommendations as needed.

For the full statement, including supporting evidence and rationale, please see NACI Statement: Interim guidance on the use of pneumococcal 15-valent conjugate vaccine (PNEU-C-15) in pediatric populations.

For more information on NACI's recommendations on the use of pneumococcal vaccines in children, please see the pneumococcal vaccine chapter in the Canadian Immunization Guide.