Beginning in November 2010, children immunized under the OHIP vaccination schedule will begin to receive the new Prevnar-13 vaccine. This replaces the older Prevnar-7 and Synflorix (PneuC-10) formulations, providing protection against a wider range of serotypes of the Streptococcus pneumoniae bacterium. These improvements are expected to help your child build a more robust and stronger immune system, and protect against the serious complications that can result from S.pneumoniae infections.

The new vaccine also means less discomfort and fewer injections for your child, since 3 doses are all that's required for most children, rather than the 4 doses given under the older regimen. Most children will receive the new vaccine at 2, 4 and 12 months. Some children with additional risk factors, such as respiratory or heart disease, diabetes or immune compromise, will benefit from an extra dose at 6 months; because of this additional booster dose, their last dose is able to be deferred by three months, and will be given at 15 months.

If your child is already over a year old, and consequently only received the older versions of the vaccine (which covered 7 or 10 serotypes of S.pneumoniae), you can choose to have them receive a single dose of the new Prevnar-13 vaccine as long as they are under 3 years of age; this extra dose is available without cost under the Ontario Health Insurance Plan. If your child is already over 3 years old, but under 6 years of age, you can still choose to get a dose of the Prevnar-13 vaccine; however, this would be an elective immunization, and although the cost would not covered by OHIP, it may be covered by your private medical insurance plan.

Prevnar-13 provides immunity against thirteen different serotypes of S.pneumoniae (1, 3, 4, 5, 6A, 7F, 9V, 14, 18C, 19A, 19F and 23F). Advantages of the new vaccine include immunization against strains of S.pneumoniae that are becoming increasingly resistant to the antibiotics typically used to treat these infections in children, as well as boosting your child's immunity against an cases of invasive pneumococcal disease due to strains not covered by the older vaccines. Prevnar-13 is the only available vaccine to provide protection against S.pneumoniae serotype 19A, which was responsible for more than 80% of recent cases of invasive pneumococcal disease in children in Toronto.

S.pneumoniae doesn't just cause pneumonia, but also a whole host of other potentially deadly infections. It can lead to ear infections (otitis media), meningitis, sepsis (blood infection) and even death in children. It is passed on to others by droplets in the air from sneezing or coughing, and also on shared objects, utensils or by close contact; it can sometimes be spread and retained in the nose and throat of many people without causing symptoms. Antibiotic treatment for it is not always effective, and it still leads to long-lasting injury or death in a small number of children with severe illness, particularly those with meningitis. Those at most risk of infection or severe illness include young children attending group day care, or children with asthma, heart disease or cancer. Every year in Canada, 15 children under five years of age die from Streptococcus pneumoniae infections, 65 get meningitis and 700 get blood infections. Many more get pneumonia and middle ear infections. It is worth noting that although children vaccinated against S.pneumoniae may still get ear infections, they are less likely to have recurrent infections or require surgery to place tubes in their ears (myringotomy) as a consequence of ear infections.

Speak to your doctor at your child's next scheduled visit to review appropriate immunization options, including Prevnar-13.

    trademarks
  • PrevnarTM and Prevnar-13TM are registered trademarks of Wyeth.
  • SynflorixTM is a registered trademark of GlaxoSmithKline Inc.
    references
  1. Toronto Public Health, fact sheet on Prevnar-13, November 2010.
  2. Canadian surveillance system : Immunization Monitoring Program, Active (IMPACT).
  3. Prevnar-13 Product Monograph, Wyeth Canada, Dec 2009.
  4. Toronto Invasive Bacterial Diseases Network, data 2008-2009, iPHIS.
  5. "Emergence of antimicrobial-resistant serotype 19A Streptococcus pneumoniae Massachusetts, 2001-2006." CDC,MMWR Oct 19, 2007, 56(41);1077-1080.
  6. Pichichero ME, Casey JR. "Emergence of a multiresistant serotype 19A pneumococcal strain not included in the 7-valent conjugate vaccine as an otopathogen in children." JAMA 2007;298(15):1772-1778.