Information on postdose 3 and postdose 4 immunogenicity

VAXNEUVANCE demonstrated robust immunogenicity, including coverage for key disease-causing serotypes 3, 22F, and 33F1,2,a

In the absence of clinical efficacy endpoints, vaccine effectiveness against invasive pneumococcal disease (IPD) may be inferred by comparing immunogenicity of PCVs to measure (or evaluate) noninferiority in clinical trials.21

Immune responses for VAXNEUVANCE against 15 serotypes postdose 3 and postdose 4a

PRIMARY SERIES COMPLETED IN THE FIRST YEAR OF LIFE19

lgG response rates
Postdose 319

  • Comparable to PCV13:
    12 shared serotypes
  • Superior to PCV13:
    Shared serotype 3 and
    unique serotypes 22F
    and 33F

lgG GMC ratios
Postdose 319

  • Comparable to PCV13:
    11 shared serotypes*
  • Superior to PCV13:
    Shared serotype 3 and
    unique serotypes 22F
    and 33F

*Additional information about postdose 3 lgG GMC ratios: The serotype-specific lgG GMC for 6A at the postdose 3 measurement for VAXNEUVANCE missed noninferiority to PCV13 by a small margin (2-sided 95% CI lower bound of GMC ratio [VAXNEUVANCE/PCV13] was 0.48, with noninferiority criterion of >0.5).

BOOSTER AT 12-15 MONTHS19

lgG GMC ratios
Postdose 419

  • Comparable to PCV13:
    12 shared serotypes
  • Superior to PCV13:
    Shared serotype 3 and
    unique serotypes 22F
    and 33F

Randomized controlled trials assessing the clinical efficacy of VAXNEUVANCE compared to PCV13 have not been conducted.

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.

aMeasurements were taken 1 month postdose 3 and 4.
CI, confidence interval; GMC, geometric mean concentration (mcg/mL); GMT, geometric mean titer; IgG, Immunoglobulin G; OPA, opsonophagocytic activity; PCVs, pneumococcal conjugate vaccines; PCV13, 13-valent pneumococcal conjugate vaccine.

VAXNEUVANCE elicited superior immune responses against the leading cause of IPD, serotype 3, vs PCV1311

In 2018-2019, serotype 3 was the #1 cause of IPD in children under 5 in the US.11,b

Superior lgG response rate for shared serotype 3 compared to PCV13

Postdose 3 (primary series)19

lgG response rate percentage point difference (VAXNEUVANCE-PCV13), 19.1 (95% CI: 14.4, 24.0).

Superior lgG GMC Ratios vs PCV13

Postdose 3 (primary series)19

lgG GMC Ratio vs PCV13, 1.70 (95% CI: 1.54, 1.86).

Postdose 4 (booster dose)19

lgG GMC Ratio vs PCV13, 1.43 (95% CI: 1.30, 1.57).

Randomized controlled trials assessing the clinical efficacy of VAXNEUVANCE compared to PCV13 have not been conducted.

bAs of 2018-2019, the top 5 IPD-causing serotypes in children under 5 years were 3, 33F, 22F, 23B, and 15C. Serotypes 15C and 23B are not included in any PCV in the US.3,11,12,13

Group-7
View safety & tolerability information
Group-12@3x-1
Read recommendations

pediatric-ref1

Reference

  1. 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
pediatric-ref2

Reference

  1. Pilishvili T, Gierke R, Farley M, et al. Epidemiology of invasive pneumococcal disease (IPD) following 18 years of pneumococcal conjugate vaccine (PCV) use in the United States. Poster presented at: International Symposium of Pneumococci and Pneumococcal Disease; June 21-24, 2020; Toronto, Canada.
pediatric-ref3

Reference

  1. Prevnar 13. Prescribing Information. Pfizer; 2019.
pediatric-ref11

Reference

  1. Data available on request from Merck & Co., Inc., Professional Services-DAP, WP1-27, PO Box 4, West Point, PA 19486-0004. Please specify information package US-PVC-00623.
pediatric-ref12

Reference

  1. Prevnar 20. Prescribing Information. Pfizer; 2023.
pediatric-ref13

Reference

  1. Pneumococcal vaccination. Centers for Disease Control and Prevention. Last reviewed February 9, 2023. Accessed February 17, 2023. https://www.cdc.gov/vaccines/vpd/
    pneumo/index.html
pediatric-ref19

Reference

  1. Kobayashi M, Farrar JL, Gierke R, et al. Use of 15-valent pneumococcal conjugate vaccine among U.S. children: updated recommendations of the Advisory Committee on Immunization Practices – United States, 2022. MMWR Morb Mortal Wkly Rep. 2022;71(37):1174-1181. doi:10.15585/mmwr.mm7137a3
pediatric-ref21

Reference

  1. Weekly epidemiological record. World Health Organization. 2013; 91-151. Accessed January 19, 2023. https://www.who.int/publications/m/item/pneumococcal-conjugate-vaccines-annex3-trs-977

Indication for VAXNEUVANCE

VAXNEUVANCE is indicated for active immunization for the prevention of invasive disease caused by Streptococcus pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 22F, 23F, and 33F in individuals 6 weeks of age and older.

Select Safety Information for VAXNEUVANCE

Do not administer VAXNEUVANCE to individuals with a severe allergic reaction (eg, anaphylaxis) to any component of VAXNEUVANCE or to diphtheria toxoid.

Some individuals with altered immunocompetence, including those receiving immunosuppressive therapy, may have a reduced immune response to VAXNEUVANCE.

Apnea following intramuscular vaccination has been observed in some infants born prematurely. Vaccination of premature infants should be based on the infant’s medical status and the potential benefits and possible risks.

The most commonly reported solicited adverse reactions in children vaccinated at 2, 4, 6, and 12 through 15 months of age, provided as a range across the 4-dose series, were: irritability (57.3% to 63.4%), somnolence (24.2% to 47.5%), injection-site pain (25.9% to 40.3%), fever ≥38.0°C (13.3% to 20.4%), decreased appetite (14.1% to 19.0%), injection-site induration (13.2% to 15.4%), injection-site erythema (13.7% to 21.4%), and injection-site swelling (11.3% to 13.4%).

The most commonly reported solicited adverse reactions in children 2 through 17 years of age vaccinated with a single dose were: injection-site pain (54.8%), myalgia (23.7%), injection-site swelling (20.9%), injection-site erythema (19.2%), fatigue (15.8%), headache (11.9%), and injection-site induration (6.8%).

The reported solicited adverse reactions in children 7 through 11 months of age who received 3 doses of VAXNEUVANCE were: fever ≥38.0°C (21.9%), irritability (32.8%), injection-site erythema (28.1%), somnolence (21.9%), injection-site swelling (18.8%), injection-site pain (18.8%), injection-site induration (17.2%), decreased appetite (15.6%), and urticaria (1.6%).

The reported solicited adverse reactions in children 12 through 23 months of age who received 2 doses of VAXNEUVANCE were: fever ≥38.0°C (11.3%), irritability (35.5%), injection-site pain (33.9%), somnolence (24.2%), decreased appetite (22.6%), injection-site erythema (21.0%), injection-site swelling (14.5%), and injection-site induration (8.1%).

Vaccination with VAXNEUVANCE may not protect all vaccine recipients.

Before administering VAXNEUVANCE, please read the accompanying Prescribing Information. The Patient Information also is available.

Indication for VAXNEUVANCE™ (Pneumococcal 15-valent Conjugate Vaccine)

VAXNEUVANCE is indicated for active immunization for the prevention of invasive disease caused by Streptococcus pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 22F, 23F, and 33F in individuals 6 weeks of age and older.

VAXNEUVANCE is indicated for active immunization for the prevention of invasive disease caused by Streptococcus pneumoniae

VAXNEUVANCE is indicated for active immunization for the prevention of invasive disease caused by Streptococcus pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 22F, 23F, and 33F in individuals 6 weeks of age and older.

Select Safety Information for VAXNEUVANCE™ (Pneumococcal 15-valent Conjugate Vaccine)

Do not administer VAXNEUVANCE to individuals with a severe allergic reaction (eg, anaphylaxis) to any component of VAXNEUVANCE or to diphtheria toxoid.

Some individuals with altered immunocompetence, including those receiving immunosuppressive therapy, may have a reduced immune response to VAXNEUVANCE.

Apnea following intramuscular vaccination has been observed in some infants born prematurely. Vaccination of premature infants should be based on the infant’s medical status and the potential benefits and possible risks.

The most commonly reported solicited adverse reactions in children vaccinated at 2, 4, 6, and 12 through 15 months of age, provided as a range across the 4-dose series, were: irritability (57.3% to 63.4%), somnolence (24.2% to 47.5%), injection-site pain (25.9% to 40.3%), fever ≥38.0°C (13.3% to 20.4%), decreased appetite (14.1% to 19.0%), injection-site induration (13.2% to 15.4%), injection-site erythema (13.7% to 21.4%), and injection-site swelling (11.3% to 13.4%).

The most commonly reported solicited adverse reactions in children 2 through 17 years of age vaccinated with a single dose were: injection-site pain (54.8%), myalgia (23.7%), injection-site swelling (20.9%), injection-site erythema (19.2%), fatigue (15.8%), headache (11.9%), and injection-site induration (6.8%).

The reported solicited adverse reactions in children 7 through 11 months of age who received 3 doses of VAXNEUVANCE were: fever ≥38.0°C (21.9%), irritability (32.8%), injection-site erythema (28.1%), somnolence (21.9%), injection-site swelling (18.8%), injection-site pain (18.8%), injection-site induration (17.2%), decreased appetite (15.6%), and urticaria (1.6%).

The reported solicited adverse reactions in children 12 through 23 months of age who received 2 doses of VAXNEUVANCE were: fever ≥38.0°C (11.3%), irritability (35.5%), injection-site pain (33.9%), somnolence (24.2%), decreased appetite (22.6%), injection-site erythema (21.0%), injection-site swelling (14.5%), and injection-site induration (8.1%).

Vaccination with VAXNEUVANCE may not protect all vaccine recipients.

Before administering VAXNEUVANCE, please read the accompanying Prescribing Information. The Patient Information also is available.

Do not administer VAXNEUVANCE to individuals with a severe allergic reaction (eg, anaphylaxis) to any component of VAXNEUVANCE or

Do not administer VAXNEUVANCE to individuals with a severe allergic reaction (eg, anaphylaxis) to any component of VAXNEUVANCE or to diphtheria toxoid.

Some individuals with altered immunocompetence, including those receiving immunosuppressive therapy, may have a reduced immune response to VAXNEUVANCE.

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