VAXNEUVANCE achieved robust immune responses during the first year of life and beyond
Immunogenicity against key disease-causing serotypes is important.1-3
In the absence of clinical efficacy endpoints, vaccine effectiveness against invasive pneumococcal disease may be inferred by comparing immunogenicity of pneumococcal conjugate vaccines to measure (or evaluate) noninferiority in clinical trials.4
The introduction of PCVs has been effective in reducing IPD in children. However, select serotypes—such as Serotype 3, 22F, and 33F—continue to contribute to the burden of disease.1,2
VAXNEUVANCE delivered a robust immune response against 15 serotypes postdose 3 as demonstrated by IgG response rates and postdose 4 GMC ratios, includinga:
- Comparable immune responses for 12 shared serotypes found in PCV13
- Superior immune responses for shared Serotype 3 vs PCV13b,c
- Superior immune responses for unique Serotypes 22F and 33F—not covered by PCV135
Randomized controlled trials assessing the clinical efficacy of VAXNEUVANCE compared to PCV13 have not been conducted.
GMC Ratios, postdose 3a
After a 3-dose primary series, VAXNEUVANCE was found to be noninferior to PCV13 for 12 out of 13 shared serotypes based on the lower bound of the 2-sided 95% CI for the GMC ratio (VAXNEUVANCE/PCV13) being >0.5. For VAXNEUVANCE, the lgG GMC for serotype 6A was just below the noninferiority criteria by a small margin, with the lower bound of the 2-sided 95% CI for the GMC ratio being 0.48 compared to the required criteria of >0.5 for noninferiority.
aMeasurements were taken 30 days postdose specified.
bPostdose 3 IgG response rate percentage point difference vs PCV13, 19.1 (95% CI: 14.4, 24.0).
cPostdose 4 IgG GMC ratio vs PCV13, 1.43 (95% CI: 1.30, 1.57).
Study design
Study 8 was a pivotal, double-blind, active comparator-controlled study in which participants were randomized to receive VAXNEUVANCE (N=860) or PCV13 (N=860) in a 4-dose series. The first 3 doses were administered to infants at 2, 4, and 6 months of age and the fourth dose was administered to children at 12 through 15 months of age. Participants also received other licensed pediatric vaccines concomitantly. Immune responses were measured by IgG response rates, IgG GMCs, and OPA GMTs for all 15 serotypes contained in VAXNEUVANCE.
CI, confidence interval; GMC, geometric mean concentration (mcg/mL); GMT, geometric mean titer; IgG, Immunoglobulin G; IPD, invasive pneumococcal disease; OPA, opsonophagocytic activity; PCV, pneumococcal conjugate vaccine; PCV13, 13-valent pneumococcal conjugate vaccine.
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References
- Gierke R, Wodi P, Kobayashi M. Epidemiology and Prevention of Vaccine-Preventable Diseases (Pink Book). 14th edition. Chapter 17: Pneumococcal disease. Centers for Disease Control and Prevention. Last reviewed May 1, 2024. Accessed August 1, 2024. https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-17-pneumococcal-disease.html?CDC_AAref_Val=https://www.cdc.gov/vaccines/pubs/pinkbook/pneumo.html
- Centers for Disease Control and Prevention (CDC). Visualization – Based on 1998-2022 serotype data for invasive pneumococcal disease cases by age group from Active Bacterial Core surveillance (ABCs). Updated July 22, 2024. Accessed September 27, 2024. https://data.cdc.gov/d/qvzb-qs6p/visualization
- Hu T, Weiss T, Owusu-Edusei K, Petigara T. Health and economic burden associated with 15-valent pneumococcal conjugate vaccine serotypes in children in the United States. J Med Econ. 2020;23(12):1653-1660. doi:10.1080/13696998.2020.1840216
- Recommendations to assure the quality, safety and efficacy of pneumococcal conjugate vaccines, Annex 3, TRS No 977. World Health Organization. October 19, 2013. Accessed January 26, 2024. https://www.who.int/publications/m/item/pneumococcal-conjugate-vaccines-annex3-trs-977
- Prevnar 13. Prescribing Information. Pfizer, Inc.; 2019.
- Lupinacci R, Rupp R, Wittawatmongkol O, et al. A phase 3, multicenter, randomized, double-blind, active-comparator-controlled study to evaluate the safety, tolerability, and immunogenicity of a 4-dose regimen of V114, a 15-valent pneumococcal conjugate vaccine, in healthy infants (PNEU-PED). Vaccine. 2023;41(5):1142-1152. doi:10.1016/j.vaccine.2022.12.054