Prevnar 20 now indicated for immunization of infants, children and adolescents

Health Canada has expanded the indications for Pfizer’s Prevnar 20 (pneumococcal 20-valent conjugate vaccine [diphtheria CRM197 protein] suspension for IM injection) to include active immunization of infants, children and adolescents from age six weeks through 17 years of age (prior to the 18th birthday).1 The vaccine is indicated for the prevention of invasive pneumococcal disease (including sepsis, meningitis, bacteremic pneumonia, pleural empyema and bacteremia) caused by Streptococcus pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 8, 9V, 10A, 11A, 12F, 14, 15B, 18C, 19A, 19F, 22F, 23F and 33F. Prevnar 20 was originally approved in 2022 for use in adults only.1 The routine vaccination schedule for infants and toddlers (6 weeks through 15 months of age) is a four-dose series. A three-dose primary series (0.5 mL intramuscular [IM] dose) is started at two months of age (as early as 6 weeks of age), with an interval of four to eight weeks between doses. A fourth (0.5 mL IM) dose is given at 11–15 months of age (at least 2 months after the third dose).1 The Prevnar 20 product monograph provides details on catch-up vaccination schedules for unvaccinated children and adolescents seven months through 17 years of age.1 Children 15 months through 17 years of age who have been completely immunized with Prevnar 13 may receive a single 0.5 mL dose of Prevnar 20. This dose of Prevnar 20 should be administered at least eight weeks after the final dose of Prevnar 13.1 Prevnar 20 should be administered by IM injection into the anterolateral aspect of the thigh in infants and the deltoid muscle of the upper arm in older children.1 The National Advisory Committee on Immunization (NACI) has not yet issued guidance on the use of Prevnar 20 in children. In February 2023, NACI published public health level recommendations on the use of pneumococcal vaccines in adults, including the use of 15-valent (Vaxneuvance) and 20-valent (Prevnar 20) conjugate vaccines.2 In March 2023, NACI issued interim guidance on the use of pneumococcal 15-valent conjugate vaccine (Vaxneuvance) in children.3 References 1. Pfizer Canada ULC. Prevnar 20 (pneumococcal 20-valent conjugate vaccine [diphtheria CRM197 protein]) product monograph. Kirkland, QC; July 21, 2023. (accessed August 25, 2023). 2. National Advisory Committee on Immunization. Public health level recommendations on the use of pneumococcal vaccines in adults, including the use of 15-valent and 20-valent conjugate vaccines. February 24, 2023. (accessed August 25, 2023). 3. National Advisory Committee on Immunization. Interim guidance on the use of pneumococcal 15-valent conjugate vaccine (PNEU-C-15) in pediatric populations. March 21, 2023. (accessed August 25, 2023).

Prevnar 20 now indicated for immunization of infants, children and adolescents

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