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New routine pneumococcal vaccination program for infants in Quebec

01/09/20

A change has recently been made to the routine infant pneumococcal vaccination program in Québec. Although Pfizer Canada typically agrees with decisions made by Québec Public Health authorities, aimed at improving the health and wellbeing of the population, the company disagrees with Québec’s decision to implement a vaccination program in which two different pneumococcal conjugate vaccines are routinely administered in the same series to infants.

The new pneumococcal vaccination schedule, consisting of two doses of the 10-valent pneumococcal conjugate vaccine (PCV10) and followed by a single dose of PREVNAR® 13 (replacing the three-dose regimen of PCV10 or three-dose regimen of PREVNAR® 13), has not been implemented in any other routine vaccination program anywhere in the world and lacks robust evidence establishing its efficacy and safety.1-6

At Pfizer we believe in making decisions in the best interest of patients that are backed by robust scientific evidence. We are proud to have a rich history in vaccine research and development and have designed vaccines to help prevent bacterial infections, like those caused by streptococcus pneumoniae.

PREVNAR® 13 is used in infant vaccination programs in 125 countries around the world, and all provinces in the rest of Canada.7,10 In fact, PREVNAR® 13 is the most widely used pneumococcal vaccine in routine pediatric immunization programs around the world, with the broadest serotype coverage of any pneumococcal conjugate vaccine.2,3,7 These programs are based on the strength of the evidence from the PREVNAR® 13 clinical development program and are supported by years of real-world experience globally.

In addition, the COVID-19 pandemic has impacted many aspects of healthcare delivery, including infant immunizations. Pfizer Canada believes that changing a PCV schedule (in which there are two different vaccines for the same immunization program) in this environment could lead to confusion among parents, caregivers and healthcare providers and lead to unintentional errors.

How will the new pneumococcal vaccination program work?

In Québec, decisions about which vaccines to include in the provincial vaccination program are made by the Ministry of Health, based on the recommendations by the Comité sur l’immunisation du Québec (CIQ).

  • Under the new program, the Province will cover the cost of two doses of a 10-valent pneumococcal vaccine and one dose of PREVNAR® 13, to be given as the third dose. The cost of three doses of PREVNAR® 13 is not covered except for children with certain high-risk conditions.11

Can my child receive the full PREVNAR® 13 schedule?

  • In order to receive a complete three-dose series of PREVNAR® 13, parents and caregivers may consult their children’s healthcare provider prior to the first vaccination appointment for a prescription of PREVNAR® 13 for the first two vaccine doses. In this instance, parents and caregivers will be required to pay out of pocket for PREVNAR® 13, but the cost may be covered by private insurance plans. Note that not all CLSCs will administer privately purchased doses of PREVNAR® 13. The third dose of PREVNAR® 13 (the one administered at 1 year of age) would be given as part of the provincial program.
  • Verbal or written consent from parents and caregivers should be obtained in order for the mixed schedule (i.e. consisting of two different pneumococcal conjugate vaccines) to be administered. Parents and caregivers should ensure they understand the difference between the two pneumococcal vaccines prior to any vaccination.

Pfizer cannot endorse the use of PREVNAR® 13 in a mixed PCV dosing schedule implemented on a population level. Both the PREVNAR® 13 and PCV10 product monographs recommend that infants who receive a first dose of one vaccine complete the vaccination course with the same product.2,3 This is consistent with the recent World Health Organization (WHO) guidance on pneumococcal conjugate vaccines in infants and children under 5 years of age.9

About PREVNAR® 13

PREVNAR® 13 is a pneumococcal conjugate vaccine indicated for active immunization of infants and children from 6 weeks to 5 years of age for the prevention of invasive pneumococcal disease and acute otitis media caused by the 13 serotypes of bacteria Streptococcus pneumoniae included in the vaccine; it is also indicated in children 6 years to 17 years of age for the prevention of invasive pneumococcal disease caused by the 13 pneumococcal serotypes included in the vaccine.2

For more information, about PREVNAR® 13, including potential side-effects, visit https://www.prevnarinfant.ca/.

About Pfizer in Canada

Pfizer Canada ULC is the Canadian operation of Pfizer Inc., one of the world's leading biopharmaceutical companies. Our diversified health care portfolio includes some of the world’s best known and most prescribed medicines and vaccines. We apply science and our global resources to improve the health and well-being of Canadians at every stage of life. Our commitment is reflected in everything we do, from our disease awareness initiatives to our community partnerships. To learn more about Pfizer Canada, visit pfizer.ca or you can follow us on LinkedIn, Facebook, Twitter or YouTube

For more information:

Corporate Affairs Canada

Pfizer Canada Media Line: 1-866-9Pfizer (1 866 973-4937)

[email protected]

References:

  1. Gouvernement du Quebec. INSPQ. Avis sur le calendrier optimal de vaccination des enfants contre les infections à pneumocoque au Québec . Septembre 2017. Available at: http://www.inspq.qc.ca. Last accessed: May 2020.
  2. Prevnar 13 Product Monograph, Pfizer Canada ULC, August 8, 2019.
  3. Synflorix Product Monograph, GlaxoSmithKline Inc. November 13, 2019.
  4. Urbancikova I, Prymula R, Goldblatt D, et. al. Immunogenicity and safety of a booster dose of the 13-valent pneumococcal conjugate vaccine in children primed with the 10-valent or 13-valent pneumococcal conjugate vaccine in the Czech Republic and Slovakia. Vaccine. 2017. doi:10.1016/j.vaccine.2017.07.103.
  5. Deceuninck G, et al. Effectiveness of three pneumococcal conjugate vaccines to prevent invasive pneumococcal disease in Quebec, Canada. Vaccine 33 (2015);2684-2689.
  6. Deceuninck G, et al. Effectiveness of pneumococcal conjugate vaccines (PCVs) to prevent serotype 19A invasive pneumococcal disease (IPD) in Quebec, Canada. Presented at ISPPD 2018, Melbourne, Australia, April 15-19,2018.
  7. Pfizer Data on File. September 2019.
  8. Public Health Agency of Canada. National Laboratory Surveillance of Invasive Streptococcal Disease in Canada, Annual Summary 2017.
  9. World Health Organization. Pneumococcal conjugate vaccines in infants and children under 5 years of age: WHO position paper – February 2019. Weekly Epidemiological Record, 22 February 2019, vol. 94, 08 (pp. 85–104).
  10. Government of Canada. Provincial and territorial routine and catch-up vaccination schedule for infants and children in Canada. Available at: https://www.canada.ca/en/public-health/services/provincial-territorial-i.... Accessed: July 2020
  11. Gouvernement du Québec, Protocole d'immunisation du Québec (PIQ). Available at: https://msss.gouv.qc.ca/professionnels/vaccination/piq-vaccins/pneu-c-va.... Last accessed July 2020.