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AAP recommends 13-valent pneumococcal vaccine
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Routine use of the 7-valent pneumococcal conjugate vaccine should be replaced by the stronger 13-valent pneumococcal conjugate vaccine, according to a policy statement from the American Academy of Physicians.
PCV13 will use the same immunization and catch-up schedules as the PCV7 for healthy children through 59 months of age and for high-risk children through 71 months of age. The vaccine will be administered as a 4-dose series, according to the statement.
The FDA licensed the use of PCV13 in children 2 through 71 months of age based on safety and immunogenicity data presented to the CDC’s Advisory Committee on Immunization Practices in February. The new vaccine is available in single-dose, pre-filled syringes that do not contain latex. It contains 6 additional capsular polysaccharides, which are responsible for substantial rates of invasive pneumococcal disease (IPD) in children.
PCV7 was introduced in 2000 and has been recommended for healthy children aged 2 to 23 months and children aged 24 to 59 months who are considered high risk.
In 2000, 14.5 million episodes of IPD occurred in children younger than 5 years and resulted in 826,000 pediatric deaths. Routine PCV7 use initially resulted in a dramatic reduction in the incidence of IPD traceable to serotypes of the bacterium Streptococcus pnemoniae. However, in 2006-2007, cases of IPD traceable to serotypes not included in the PCV7 vaccine were on the rise and only 2% of cases were caused by the serotypes found in PCV7.
Previously administered PCV7 does not count toward the completion of the recommended series. Children who started their vaccine with one or more doses of PCV7 should finish their series with PCV13, and children who received their vaccines with the PCV7 vaccine should receive a single supplemental dose of PCV13 at least 8 weeks after their last dose of PCV7 when it is available.
Children aged 6 to 18 years with sickle cell disease, anatomic or functional asplenia, immunocompromised conditions, cochlear implants or cerebrospinal fluid leaks may receive a single dose of PCV13.
The AAP also recommends that children at high risk who are 2 years or older should also receive a 23-valent pneumococcal polysaccharide vaccine [PPSV23] at least 8 weeks after their last dose of PCV13. Children with an underlying medical condition have an increased risk of IPD, therefore they should receive PPSV23 at 2 years of age or as soon as possible after their diagnosis of a chronic illness. PPSV23 is not covered by the Vaccine Injury Compensation Program. – by Amanda Jamieson
AAP. Pediatrics.10.1542/peds.2010-1280