Prevenar 13 (PCV 13): thirteen valent pneumococcal conjugate vaccine

Prevenar 13 is 13 valent pneumococcal conjugate PCV-13 vaccine. It is used to prevent the diseases caused by Streptococcus pneumoniae strains. It gives immunity against Streptococcus pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F. These all antigens are polysaccharide in nature. Being polysaccharide they are not very effective in inducing immunity in children less than 2 years of age. In those above 2 years of age they cannot induce long term memory in immunity. So these antigens are chemically activated and covalently linked to non toxic diphtheria protein carrier CRM197. This is called as conjugation. After the process of conjugation the above problem is solved. This is conjugated vaccine.

Each 0.5 ml dose contains 2.2 mcg of saccharide of serotypes 1, 3, 4, 5, 6A, 7F, 9V, 14, 18C, 19A, 19F, AND 23F. It also contains 4.4 mcg of serotype 6B. It also contains 0.02% polysorbate 80 and 0.125 mg of aluminium as aluminium phosphate adjuvants.

Prevenar 13

Prevenar 13 vaccine is available in injection form. It is ready to inject liquid. It is available in pre-filled syringe. Generally sterile needle for IM injection is provided with it.

How Prevenar 13 is given?

Prevenar 13 is given by injection. It is generally given on antero-lateral aspect of thigh in infants and deltoid muscles in adult. Safety injection precautions should be followed while giving injection. This injection should not be given intravenous, subcutaneous or intradermal as safety and immunogenicity of such route is not known.

How does Prevenar 13 vaccine works?

Prevenar 13 vaccine is method of active immunization. When this injection is given to the infant or child, the serotype antigens in it which are conjugated to CRM197 protein get recognized by the immune system. Immune system forms antibodies against it. Immune system also forms the memory immunity against all these antigens, so when actual infection with same serotypes occur the immune mechanism fastly ramps up the fight and the infection is brought under very effectively and also the disease stage of infection is prevented. As body learns to fight infection even the commensal infection by above serotype bacteria is fought back. It also changes the carrier pattern of these serotypes in normal population. Thus to some extent even the contacts are protected if sufficiently large population is vaccinated with this vaccine. Booster dose is used to boost the immune response and it also helps to confer the prolonged immunity.

Which diseases are prevented by Prevenar 13?

The diseases caused by the serotypes of Streptococcus pneumoniae contained in vaccine are prevented.

These include pneumonia, otitis media, meningitis, Some streptococcal skin infections.

How Prevenar 13 vaccine is stored?

This vaccine is needed to be stored in the temperature range 2-8 degree Celsius and cold chain should be maintained during transport and storage till injection is administered.

Accidentally frozen doses should not be used and discarded.

At what age this Prevenar 13 vaccine is given?

Prevenar 13 is given at age 6, 10, 14 weeks along with DPT, HiB, IPV and Hepatitis B, oral rotavirus vaccine.

One booster dose is needed at 15-18 months of age. So currently 3+1 dose schedule is recommended for those who are less than 6 months of age.

What if someone has missed the dose of Prevenar 13?

  • If previously Prevenar 13 was not given and current age of infant is 6-12 months then 2 doses 1 month apart followed by one booster at 15-18 months of age is given.
  • If previously no dose of Prevenar-13 was given and child is 12-18 months of age 2 doses at least 1 month apart are recommended.
  • For those who haven’t been vaccinated previously with Prevenar-13 and those who are above age 18 months a single dose of prevenar 13 should be given.
  • This vaccine is indicated for adult if they are hypertensive, diabetic and age more than 50 years or any other reason of reduced immunity.
Age at first dose Prevenar 13 vaccineSchedule
Less than 6 months3 doses at least 1 month apart each and a booster at 15-18 months
6-12 months2 doses 1 month apart and a booster at 15-18 months
12-18 months2 doses 1 month apart
Above 18 months Single dose of PCV 13
Those who received all doses PCV 10 previouslySingle dose PCV 13
Adults who have risk of pneumococcal infection like diabetics, hypertensives and immunocompromised and age above 50 yearsSingle dose
Prevenar 13 vaccine schedule

Safety of Prevenar 13 given with other vaccines:

There were some reports of increased chances of hypotonic hyporesponsive episodes and fever, convulsion were noted when Prevenat 13 were concomitantly administered with Infanrix hexa.

What are side effects of Prevenar 13 vaccine?

  • Very common side effects are fever, local pain and swelling, irritability, loss of appetite, diarrhea, headache, loss of sleep, restlessness.
  • These all side effects are usually mild and can be managed at home with or without medications.
  • Fever can be moderate to high grade after vaccination and subsides with oral paracetamol and sponging.
  • Local pain and swelling can be managed with paracetamol and local cold fomentation as needed.
  • Loss of appetite and irritability usually subsides buy its own after some hours.
  • For diarrhea frequency of breast feeding is increased and oral rehydrating solution can be given.
  • Headache may subside by its own or may need oral paracetamol.
  • Though side effects may occur they are usually for short period and milder than diseases that are prevented by the vaccine.

To whom this vaccine should be avoided?

This vaccine has very few contraindications as listed below:

  • Do not give this vaccine who are allergic to any of components of this vaccine.
  • Avoid this vaccine to patient who had got allergic anaphylactic reaction at the time of the previous dose.

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