July 12, 2023
Following a late June meeting of the CDC’s Advisory Committee on Immunization Practices, Medpage Today shared the unanimous agreement to include 20-valent pneumococcal conjugate vaccine (PCV20; Prevnar) as an option for children in the United States. The 14 committee members voted in favor of four proposals relating to PCV20 and also added new underlying conditions to its list of risk considerations, including chronic kidney disease, chronic liver disease, moderate persistent or severe persistent asthma, and those with renal failure on maintenance dialysis.
The four proposal recommendations for PCV20 were routine use in children ages 2-23 months, current dosing or catch-up for children with incomplete vaccination status, children with a risk condition ages 2-18 years, and children ages 6-18 years with a risk condition and had not received PCV13, PCV15, or PCV20.
The committee acted following a winter 2022 season that proved to be severe, showing rates of invasive pneumococcal disease exceeding 1.20 per 100,000 children under the age of five. Rates, comparatively, for 2018 to 2021 were all well below 1 per 100,000. The FDA approved PCV20 in April for children and infants. It offers the broadest serotype coverage of any PCV, adding serotypes 8, 10A, 11A, 12F, and 15B to the PCV15 vaccine. Committee members expressed concern over the lack of clinical data for the PCV20 and PCV15 vaccines. There is only immunogenicity data for these, no efficacy data for either.
PIDS members Sarah Long and Grace Lee who are also ACIP members appear in the article. Dr. Long is quoted saying, “Pneumococcal vaccines at the moment are messy, and we’re trying to make them a little bit coordinated with what’s already out there.” Dr. Lee, ACIP chair, said multiple vaccine options were important given that mentioned lack of efficacy, particularly in children, and added, “I don’t believe we have enough data to make a preferential recommendation [between PCV15 or PCV20] at this time.”