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PCV13, PCV15 or PCV20: Which vaccine is best for children in terms of immunogenicity?
Philippe De Wals1,2,3
1Department of Social and Preventive Medicine, Laval University, Québec City, QC.
Insights
New pneumococcal conjugate vaccines (PCV15 and PCV20) show lower immunogenicity than PCV13 in toddlers. Post-marketing studies are needed to confirm real-world effectiveness and benefits compared to PCV13.
Area of Science:
- Vaccinology
- Immunology
- Pediatrics
Background:
- Pneumococcal conjugate vaccines (PCV15 and PCV20) were approved based on immunogenicity compared to PCV13.
- PCV13 itself was authorized using PCV7 as a reference for immunogenicity.
Purpose of the Study:
- To compare the immunogenicity of PCV15, PCV20, and PCV13 in toddlers.
- To evaluate the impact of different dosing schedules (2+1 vs. 3+1) on vaccine immunogenicity.
Main Methods:
- Utilized functional opsonophagocytic activity (OPA) titre ratios.
- Compared data from randomized trials involving PCV7, PCV13, PCV15, and PCV20.
Main Results:
- PCV15 and PCV20 demonstrated lower immunogenicity than PCV13 for most serotypes.
- PCV15 and PCV20 showed similar immunogenic responses to each other.
- PCV7 was more immunogenic than PCV13, indicating PCV15 and PCV20 are less immunogenic than PCV7.
- A 2+1 dose schedule resulted in reduced immunogenicity compared to a 3+1 schedule for all evaluated vaccines.
Conclusions:
- PCV15 and PCV20 may be less immunogenic than PCV13 and PCV7.
- Further post-marketing studies are essential to determine the real-world effectiveness and benefits of PCV15 and PCV20 over PCV13.
Background:
The new 15- and 20-valent pneumococcal conjugate vaccines (PCV15 and PCV20) have been marketed on the basis of immunogenicity criteria, one of them being a non-inferior response as compared with the 13-valent vaccine (PCV13). In the past, PCV13 was also authorized on the basis of the same criteria, using the 7-valent vaccine (PCV7) as a reference.
Methods:
Our aim was to compare the immunogenicity of these three vaccines in toddlers. Functional opsonophagocytic activity (OPA) titre ratios measured in the same and different randomized trials were computed to assess the respective immunogenicity of these four products.
Results:
Results suggest that both PCV15 and PCV20 are less immunogenic than PCV13 for most common serotypes and that the two new vaccines induce a broadly similar response. The PCV7 vaccine was already slightly more immunogenic than PCV13 meaning that PCV15 and PCV20 compare poorly with PCV7. Results also point towards a reduced immunogenicity of the 2+1 dose schedule compared to the 3+1 dose schedule for PCV13, PCV15 and PCV20.
Conclusion:
Post-marketing studies will have to be conducted to assess the effectiveness of PCV15 and PCV20 and their real-life benefit over PCV13.
