![]() Recent systematic reviews continue to support the effectiveness of PCV13 against invasive pneumococcal disease (IPD)** and pneumococcal pneumonia among adults ( 4, 5). The recommended pneumococcal vaccine doses and intervals between doses differ by age and underlying conditions, making adult pneumococcal vaccine recommendations complicated. On the basis of review of accrued evidence, the PCV13 recommendation was changed in 2019 to shared clinical decision-making for adults aged ≥65 years without an immunocompromising condition, cerebrospinal fluid leak, or cochlear implant. In 2012, ACIP recommended administration of PCV13 in series with PPSV23 for adults with immunocompromising conditions, ¶ cerebrospinal fluid leaks, or cochlear implants ( 2), and in 2014, the recommendation was extended to all adults aged ≥65 years ( 3). children in 2010, and indirect effects from its use in children reduced PCV13-type pneumococcal disease incidence in all adult groups ( Figure). PCV13 was first recommended for use in U.S. PPSV23 has been recommended for use in the United States since the 1980s for adults aged ≥65 years and for younger adults with underlying conditions that increase their risk for pneumococcal disease ( 1). This was simplified in the new recommendations. adults and the recommendations varied by age and risk groups. ![]() Before this, PCV13 and PPSV23 were recommended for use for U.S. ACIP employed the Evidence to Recommendation (EtR) framework, † using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) § approach to guide its deliberations regarding use of these vaccines. On October 20, 2021, the Advisory Committee on Immunization Practices (ACIP) recommended use of either PCV20 alone or PCV15 in series with PPSV23 for all adults aged ≥65 years, and for adults aged 19–64 years with certain underlying medical conditions or other risk factors* who have not previously received a PCV or whose previous vaccination history is unknown. Antibody responses to two additional serotypes included in PCV15 were compared to corresponding responses after PCV13 vaccination, and antibody responses to seven additional serotypes included in PCV20 were compared with those to the 23-valent pneumococcal polysaccharide vaccine (PPSV23) (Merck Sharp & Dohme Corp.). In 2021, 20-valent pneumococcal conjugate vaccine (PCV) (PCV20) (Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.) and 15-valent PCV (PCV15) (Merck Sharp & Dohme Corp.) were licensed by the Food and Drug Administration for adults aged ≥18 years, based on studies that compared antibody responses to PCV20 and PCV15 with those to 13-valent PCV (PCV13) (Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc.). ![]()
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