New shift for pneumococcal vaccine dosing to protect against meningitis and pneumonia

Pharma News: A unique study published this month outlines new ways to protect more of the world’s population from vaccine-preventable diseases.

The findings, detailed in The Lancet Infectious Diseases, showed that administering fewer doses of a pneumococcal conjugate vaccine (PCV) could still protect against pneumococcal diseases such as meningitis and pneumonia.

We have seen another major shift in human papillomavirus (HPV) vaccination due to recent international changes, where a move from 2- and 3-dose schedules to a single dose vaccine schedule will be implemented for the Australian population. These changes will impact MSD, Seqirus and GSK.

The pneumococcal vaccine randomised trial, known as Vietnam Pneumococcal Trial II, was a collaboration between Murdoch Children’s Research Institute, Pasteur Institute of Ho Chi Minh City and Menzies School of Health Research.

It showed that providing PCV doses to Vietnamese infants at 2 months and 12 months (1+1 vaccine schedule) reduced the presence of the pneumococcal bacterium found in the nose of healthy children (known as carriage) by up to two thirds.

Currently, 3 doses of PCV are recommended for infants. The Vietnam Pneumococcal Trial II adds to evidence suggesting a 1+1 vaccine schedule could be suitable in countries where pneumococcal vaccinations are already being implemented, or where they are yet to be used alongside catch-up campaigns. The United Kingdom has had a 1+1 PCV vaccine schedule since 2020, demonstrating the value of this approach.

The other key finding from the study was that one PCV dose provided at 12 months of age (0+1 vaccine schedule) could also provide some herd protection to reduce disease in humanitarian crises and remote settings where PCV access is challenging.

In both vaccine schedule types, the 2 widely available PCVs were tested. Both vaccines were found to be effective at generating immunity and reducing carriage.

Menzies School of Health Research Epidemiologist, trial manager and lead author, Beth Temple, said “Vaccination strategies that increase the accessibility and affordability of vaccines are urgently needed, and reduced vaccine schedules are one way to address this. If fewer doses can be given, this helps reduce the cost, logistics and resources, and quantity needed to vaccinate a wider group of people. The findings of the study provide substantial evidence to support the use of reduced-dose PCV schedules, and in turn can help protect more of our population against pneumococcal diseases.”

These findings, released during of World Immunisation Week (24 -30 April) highlight the action needed to promote the use of vaccines to protect people in all settings from disease. Pneumococcal vaccines have been available since 2000, but it is estimated that 60% of children across the globe remain unvaccinated.

Murdoch Children’s Research Institute’s Professor Kim Mulholland, principal investigator, said “Severe pneumonia, usually due to Streptococcus pneumoniae or pneumococcus, remains a major cause of child death in the poorer areas of the world. The children at highest risk are those living in poor, crowded housing, particularly those suffering from malnutrition.

“Sadly, 23 years after PCVs were first introduced, these children are still the most likely to miss out on the vaccine. A fair world would have seen to it that these children were vaccinated first. Our studies in this area are designed to help authorities to protect all children, not just those from wealthy families.”

Pneumococcal vaccines available in Australia are Pfizer’s Prevenar (13vPCV), Merck Sharp & Dohme’s (MSD) Vaxneuvance (15vPCV) and Pneumovax 23 (23vPPV) vaccines.

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