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Pneumococcal polysaccharide conjugate vaccine (13-valent, adsorbed): in older adults
1Adis, Auckland, New Zealand. demail@springer.com
Insights
Pneumococcal conjugate vaccine PCV13 offers protection against pneumococcal disease. Studies show PCV13 is noninferior to PPV23 in adults, with superior responses for some serotypes and acceptable safety profiles.
Area of Science:
- Immunology
- Vaccinology
- Public Health
Background:
- Pneumococcal polysaccharide conjugate vaccine (13-valent, adsorbed) [PCV13] is approved for children and adults aged ≥50 years.
- Pneumococcal disease prevention remains a public health priority, necessitating evaluation of vaccine efficacy and immunogenicity in diverse adult populations.
Purpose of the Study:
- To evaluate the immunogenicity and safety of PCV13 in adults aged 50 years and older.
- To compare PCV13 responses with the 23-valent pneumococcal polysaccharide vaccine (PPV23) in various adult age groups.
- To assess antibody responses to PCV13 when co-administered with inactivated influenza vaccine.
Main Methods:
- Randomized controlled trials were conducted in adults aged 60-64 years (PPV23-naive) and ≥70 years (previously vaccinated with PPV23).
- Opsonophagocytic assay (OPA) geometric mean titres (GMTs) were used to assess immune responses.
- Antibody responses in adults aged 50-59 years were compared to those aged 60-64 years.
- Concomitant administration of PCV13 with trivalent inactivated influenza vaccine was studied in adults aged 50-59 or ≥65 years.
Main Results:
- PCV13 was noninferior to PPV23 in OPA GMTs for 12 common serotypes in adults aged ≥60 years.
- PCV13 demonstrated superior responses for serotype 6A and met superiority criteria for most serotypes.
- Antibody responses to PCV13 in adults aged 50-59 years were noninferior to those aged 60-64 years.
- Concomitant administration of PCV13 and influenza vaccine showed noninferiority, with some exceptions for specific serotypes/strains in older adults.
- Adverse events were mostly mild-to-moderate, with similar rates of serious events between PCV13 and PPV23 recipients.
Conclusions:
- PCV13 elicits robust immune responses in adults aged 50 years and older, comparable or superior to PPV23 for key pneumococcal serotypes.
- PCV13 demonstrates a favorable safety profile in adult populations.
- Co-administration of PCV13 with influenza vaccine is immunogenically noninferior, supporting vaccination schedule flexibility.
Abstract:
Pneumococcal polysaccharide conjugate vaccine (13-valent, adsorbed) [PCV13] is approved for protection against pneumococcal disease in children aged 6 weeks to 5 years and adults aged ≥50 years. In randomized trials in adults aged 60-64 years (not previously vaccinated with 23-valent pneumococcal polysaccharide vaccine [PPV23]) and ≥70 years (previously vaccinated with PPV23), PCV13 was noninferior to PPV23 in opsonophagocytic assay (OPA) geometric mean titres (GMTs) for all 12 serotypes common to the two vaccines. More PCV13 than PPV23 recipients had ≥4-fold increases in serotype 6A OPA GMTs (serotype 6A is not included in PPV23). PCV13 recipients also had higher OPA GMTs and met superiority criteria for most serotypes. Adults aged 50-59 years had antibody responses to PCV13 that were noninferior to those in adults aged 60-64 years for all included serotypes. PCV13 administered concomitantly with trivalent inactivated influenza vaccine in adults aged 50-59 or ≥65 years produced antibody responses that were noninferior to those following sequential administration, except for influenza strain A/H3N2 and pneumococcal serotype 19F in those aged ≥65 years. Antibody responses were numerically higher with sequential administration, although the clinical significance of this is unknown. Adverse events within 14 days of vaccination were mostly of mild-to-moderate severity, with serious events occurring in 0.2-1.4% of PCV13 and 0.4-1.7% of PPV23 recipients.
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