Recommended usage of Prevnar® 13 (Pneumococcal Conjugate 13)

Advisory Alert

November 9, 2015

*Cette information est seulement disponible en anglais.

For all reporting, inquiries or comments, please contact:
Sudbury & District Health Unit at 705.522.9200, ext. 301; after hours 705.688.4366.

Dear Colleagues:

Re: Recommended Usage of Prevnar® 13 (Pneumococcal Conjugate 13)

I am writing to you today in response to inquiries the Health Unit has received from clinicians regarding the use of Prevnar® 13 publicly funded vaccine for healthy adults.

In accordance with recommendations from the Canadian Immunization Guide, pneumococcal conjugate vaccine is not currently recommended for healthy adults. In Canada, invasive pneumococcal disease (IPD) is most common in the very young (those under age 5—especially those under age 2), the elderly (those over age 65), and in certain groups with health or other conditions that place them at high risk* for infection.

For more information about IPD distribution in Canada, refer to:

• PHAC IPD (http://www.phac-aspc.gc.ca/im/vpd-mev/pneumococcal-pneumococcie-eng.php).
• Comprehensive updates on the epidemiology of IPD in Canada are published periodically in the Canadian Communicable Disease Report (CCDR) (http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/index-eng.php)

Publicly funded vaccine is only to be used for immunization of persons who meet Ministry of Health and Long-term Care eligibility requirements as follows:

Eligibility for publicly funded Prevnar® 13 vaccine (as per the Ontario Publicly Funded Immunization Schedule, October 2015):

1. Routine Vaccine Program
   • Infants and children 6 weeks to 4 years of age
2. High-risk Vaccine Program:
   • Persons who meet the pneumococcal conjugate 13 high-risk* criteria including:
     • Infants 6 weeks to 6 months of age (eligible for an extra dose)
     • Adults ≥ 50 years of age

 *The following summarizes high-risk conditions for which Prevnar® 13 vaccine is publicly funded:

• Infants 6 weeks to 6 months with the following high-risk medical conditions can receive an additional (4th) dose of vaccine:
  • asplenia (functional or anatomic), splenic dysfunction
  • cardiac disease (chronic)
  • cerebral spinal fluid leak (chronic)
  • cochlear implant recipients (pre/post implant)
  • congenital (primary) immunodeficiencies involving any part of the immune system, including B-lymphocyte (humoral) immunity, T-lymphocyte (cell) mediated immunity, complement system (properdin or factor D deficiencies), or phagocytic functions
  • diabetes mellitus
  • HIV
  • immunocompromising therapy including use of long-term systemic corticosteroid, chemotherapy, radiation therapy, post-organ transplant therapy, certain anti-rheumatic drugs and other immunosuppressive therapy
  • liver disease (chronic), including hepatitis B and C, and hepatic cirrhosis due to any cause
  • malignant neoplasms, including leukemia and lymphoma
  • renal disease (chronic), including nephrotic syndrome
  • respiratory disease (chronic), excluding asthma, except those treated with high-dose corticosteroid therapy
  • sickle-cell disease and other sickle cell haemoglobinopathies
  • solid organ or islet cell transplant (candidate or recipient)
• Adults ≥ 50 years of age with the following high risk medical conditions:
  • asplenia (anatomical or functional) (1 dose)
  • congenital (primary) immunodeficiencies involving any part of the immune system, including B-lymphocyte (humoral) immunity, T-lymphocyte (cell) mediated immunity, complement system (properdin or factor D deficiencies), or phagocytic functions (1 dose)
  • HIV (1 dose)
  • HSCT recipient (3 doses)
  • immunocompromising therapy including use of long term corticosteroids, chemotherapy, radiation therapy, post-organ-transplant therapy, biologic and non-biologic immuno- suppressive therapies for rheumatologic and other inflammatory diseases (1 dose)
  • malignant neoplasms including leukemia and lymphoma (1 dose)
  • sickle cell disease or other hemoglobinopathies (1 dose)
  • solid organ or islet cell transplant (candidate or recipient) (1 dose)

In addition, persons ≥ 6 weeks of age with other high-risk medical conditions, as per the Canadian Immunization Guide (CIG), could benefit from immunization with Prevnar® 13. The vaccine is not publicly funded for these purposes and would be available through prescription and purchase from a pharmacy or is available through purchase at the SDHU.

This item was last modified on September 9, 2016