Synflorix: Pneumococcal polysaccharide conjugate vaccine

Synflorix: Pneumococcal polysaccharide conjugate vaccine (PCV 10)

Synflorix is 10 valent pneumococcal polysaccharide conjugate PCV 10 vaccine. It is used to prevent the diseases caused by Streptococcus pneumoniae strains. It gives immunity against Streptococcus pneumoniae serotypes 1, 4, 5, 6B, 7F, 9V, 14, 18C, 19F, 23F and cross reactive serotype 19A. 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 diphtheria toxoid protein carrier protein, Tetanus toxoid carrier protein and protein D of non Typeable Haemophilus influenzae. This is called as conjugation. After the process of conjugation the above problem is solved. This is conjugated vaccine.

Each 0.5 ml of Synflorix contains
Polysaccharide of serotype 1, 5, 6B, 7F, 9V, 14, 23F1 mcg
Polysaccharide of Serotype 4, 18C, 19F3 mcg
Adsorbed on aluminium phosphate0.5 mg
Conjugated to protein D carrier protein13 mg
Conjugated to tetanus toxoid carrier protein8 mcg
Conjugated to diphtheria toxoid carrier protein5 mcg
Sodium chloride and water for injection

Synflorix vaccine

Synflorix vaccine is available in injection form. It is ready to inject liquid. It is available in prefilled syringe. Generally sterile needle for IM injection is provided with it. It looks hazy cloudy in appearance normally becomes homogenous when shaken gently.

How Synflorix vaccine is given?

Synflorix vaccine is given by injection. It is generally given on antero-lateral aspect of thigh in infants. Safety injection precautions should be followed while giving injection. This injection should not be given intravenous, subcutaneous or intra-dermal as safety and immunogenicity of such route is not known. The vaccine that has passed its expiry date should not be used. The vaccine should be discarded if passes expiry date or frozen or was kept out of suggested temperature range. While discarding the disposables or discarding the unused vaccines proper biomedical waste management protocols should be followed to protect environment from damage.

How does Synflorix vaccine work?

Synflorix 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 carrier proteins 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 Synflorix?

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 Synflorix 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 Synflorix vaccine is given?

Synflorix 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 Synflorix vaccine?

  • If previously Synflorix 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 child of age 12 months to 5 years comes unvaccinated 2 doses 1-2 months apart can be given.
  • Special population of children suffering from immunodeficiency, HIV, sickle cell disease and splenic dysfunction should be given the vaccine as they have more risk of getting invasive pneumococcal disease.
  • The safety data above 5 years age have not yet been established for those above 5 years age.
  • The safety data is yet not available for adults.
  • Adults and those with pregnancy and in lactation should not be given this vaccine.

Safety of Synflorix given with other vaccines:

This vaccine can be safely given with other vaccines and Infanrix Hexa painless vaccine.

What are side effects of Synflorix vaccine?

  • Very common side effects are fever, local pain and swelling, irritability, loss of appetite, nausea, 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 nausea 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.
  • Severe reactions allergic in origin and causing anaphylaxis which can be life threatening are extremely rare to occur. The center at which vaccination is given should be equipped with facility to manage anaphylactic reaction.

To whom Synflorix vaccine should not be given?

There are very few contraindications to this vaccine. This vaccine should be avoided in those:

  • Who are above age 5 year.
  • Those who are pregnant.
  • Those who are breast feeding their babies.
  • Those who are allergic to any of the components of this vaccine.
  • Those who had anaphylactic or allergic reaction at the time of the previous dose.

What is difference between Synflorix and Synflorix pfs?

Synflorix pfs comes in prefilled syringe which reduces chance of contamination while preparing and injecting the vaccine. Contents and effects are same for the both vaccines.

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