Pneumovax® 23 (Pneumococcal vaccine, polyvalent) (Pneumovax® 23)

The vaccine, called Pneumovax 23, is used to prevent pneumococcal infection, which combines a number of diseases caused by pneumococcus, a type of streptococcus.

This infection is quite common, due to the ease of transmission of microbes and their resistance to many antibiotic drugs.

Pneumococci cause the development of diseases such as:

• pneumonia (pneumoniae);
• ear disease (otitis);
• bacterial meningitis;
• pleurisy;
• endocarditis;
• arthritis.

Neither adults nor children can avoid infection, therefore, to effectively prevent its carriage or development of the disease, vaccination with Pneumovax 23 is necessary.

pharmachologic effect

This drug is a pneumococcal polyvalent vaccine, which is used for prophylactic purposes - to prevent pneumococcal infections of various localizations.

In particular, the vaccine is intended for the prevention of pneumonia, meningitis , sepsis , and otitis media . The Pneumo 23 vaccination promotes the formation of specific immunity to twenty-three serotypes of Streptococcus pneumoniae bacteria.

After the Pneumo 23 vaccine has been administered once, a person has specific immunity for five years. The drug is widely used in children after reaching the age of two to prevent the development of pneumococcal infection in them.

Pharmacological properties

Pharmacodynamics

The polyvalent vaccine for the prevention of pneumococcal infections Pneumovax 23 contains a mixture of highly purified capsular polysaccharides from 23 of the most invasive and common serotypes of pneumococcus Streptococcus pneumoniae. This vaccine contains approximately 90% of the serotypes that cause pneumococcal infections in developed and developing countries. In Russia, according to scientific publications, the most common serotypes of pneumococcus are: 3, 6B, 14, 19F, 23F. Drug-resistant pneumococcal infections are most often caused by serotypes 6B, 19A, 19F and 23F.

Pneumococcal disease is a leading cause of morbidity and mortality worldwide. It causes dangerous diseases such as meningitis, pneumonia, otitis media and bacteremia.

In the United States and other countries, drug-resistant strains of Streptococcus pneumoniae are becoming more common every year. It is known that in some regions more than 35% of pneumococcal strains are resistant to penicillin. Many of these strains are also resistant to other antimicrobial drugs (cephalosporins, trimethoprim-sulfamethoxazole, erythromycin, etc.), so the importance of vaccination should not be underestimated.

It has been established that the capsular polysaccharides of the vaccine induce the production of antibodies that effectively protect against pneumococcal infection. The immunogenicity of each of the 23 types of capsular antigens has been confirmed by clinical studies.

Typically, protective antibody levels appear by the third week after immunization. Bacterial capsular polysaccharides stimulate the formation of antibodies through mechanisms that have little to do with the participation of T lymphocytes. This is why in children under 2 years of age, due to the immaturity of the immune system, the immune response is most often unstable or weak.

After administration of Pneumovax 23, the levels of specific antibodies gradually decrease, and repeated vaccination is required after 5–10 years. In children and the elderly, serotype-specific antibody levels decline more rapidly, so booster vaccination may be required to ensure continued protection against pneumococcal disease.

The effectiveness of vaccination was studied by the US Centers for Disease Control and Prevention. In persons over 6 years of age, the protective effectiveness of immunization against infections caused by serotypes included in Pneumovax 23 was 57%; in patients of special groups (patients with diabetes, people with congestive heart failure, coronary heart disease, chronic heart disease and people with anatomical absence of the spleen) - 65–84%; in immunocompetent individuals over 65 years of age – 75%.

For some groups of patients with a reduced immune response, the effectiveness of the vaccine could not be confirmed because it was not possible to recruit a sufficient number of unvaccinated individuals into each disease group. Based on the results of the studies, it can be assumed that vaccination can provide protection for up to 9 years from the date of the first dose.

With increasing time after vaccination, its effectiveness decreases, especially in old age (in people over 85 years of age).

Pharmacokinetics

No data.

Indications for use

The use of Pneumo 23 is indicated to prevent the development of pneumococcal infections of different localizations. Recommended for use by children from the age of two.

The vaccine is recommended for anyone who has an increased risk of becoming infected with Streptococcus pneumonia. In particular, this vaccination should be given to elderly people, children with weakened bodies, who are subject to frequent hospitalization.

Vaccination is also recommended for children who often suffer from diabetes , chronic bronchitis, respiratory and heart failure.

People who abuse nicotine and alcohol, those who have weakened immunity, and leakage of cerebrospinal fluid are also at risk of contracting the infection.

What are the indications for immunization with the Pneumo 23 vaccine?

The effectiveness of the drug has been studied and proven by many years of experience in vaccinations and its study in laboratory conditions. According to the data, she saved and saved the lives of many people.

Attention! If you or your child is often sick or has a pathology that directly or indirectly leads to a decrease in immunity, consult a doctor! You may need a pneumonia vaccine.

Statistics show that during epidemics, people vaccinated with Pneumo 23 manage to avoid clinical manifestations of the disease in 85-90% of cases. In this regard, risk groups for contracting this virus have been compiled and vaccinations are recommended.

Vaccination is indicated for certain categories of people:

• if age is 65 years and above;
• people whose activities involve working in specialized institutions;
• with the presence of chronic pathologies and damage to the heart, respiratory system and excretory system (kidneys);
• smokers, alcoholics, drug addicts;
• persons with severe forms of damage to the liver, pancreas, and diabetes mellitus;
• maladjusted contingent;
• with various immunodeficiency conditions, including HIV;
• the spleen was removed;
• a child from 2 to 5 years old with a weakened immune system and often ill for a long time;
• a child over two years old suffering from severe anemia or hydrocephalus.

All these diseases and conditions sooner or later lead to suppression of the immune system, which can have a detrimental effect on their condition and cause illness.

Contraindications

Vaccination with the drug should not be given to people who have a history of hypersensitivity after receiving the pneumococcal vaccine.

Immunization is not carried out for people suffering from acute infectious and non-infectious diseases, hyperthermia. The vaccine should not be administered during a relapse of chronic diseases.

Vaccination is allowed only after the patient has entered stable remission or has fully recovered.

The drug should not be administered to people who have received a pneumococcal vaccine over the previous three years (with the exception of people at risk, as well as those who have received immunosuppressive treatment).

It should be taken into account that a recent pneumococcal infection is not a contraindication to the Pneumo 23 vaccination.

Manufacturer and what Pneumo 23 protects against

The manufacturer of this vaccination drug is the famous French pharmaceutical company Sanofi Pasteur.

The drug is aimed at creating active immunity in the patient’s body against pneumococcal bacteria. The peculiarity of this infection is that it can cause a wide variety of diseases (inflammation of the lungs, joints, meninges and even the heart) and is often in the body in an inactive form (does not lead to the development of a clear clinical picture), making a person a carrier and distributor .

Important! The danger of pneumococcal infection lies in the fact that it can be contracted not only from a sick person (of course, we try in every possible way to avoid such contact), but also from a carrier who appears to be absolutely healthy, but at the same time poses an epidemiological threat. This is what determines the fact that it is almost impossible for people visiting crowded groups (kindergartens, schools, universities, offices) to avoid direct contact with this infection. Therefore, doctors are calling for vaccination, which can significantly reduce the prevalence of infection.

Side effects

After the patient receives Pneumo 23, he may develop some local negative reactions: the appearance of compaction, swelling, pain, hyperemia in the place where the drug was injected.

In most cases, such manifestations are moderate and disappear very quickly, and no specific treatment is required.

Very rarely (in isolated cases) during the use of Pneumo 23, severe local manifestations may develop, including the Arthus phenomenon . All these side effects go away without additional treatment.

People whose bodies have a high level of anti-pneumococcal antibodies may develop hyperthermia, and sometimes, very rarely, the body temperature can rise to 39 degrees or higher.

There is information about isolated cases of arthralgia, adenopathy, skin rash and anaphylactoid reactions. If these or other undesirable manifestations develop, you should immediately inform your doctor.

What kind of troubles does pneumococcal infection threaten?

Pneumococcus is extremely often the “culprit” of a number of diseases, which subsequently make themselves felt for a long time. Therefore, before it is too late, you need to get vaccinated against this seemingly harmless, but such an insidious microbe.

This type of bacterial infection causes various diseases that affect vital organs. The transmission route is the most common: airborne droplets, less often contact. Infection can occur from a patient through talking, breathing, sneezing, coughing. They can also become infected through dishes, handshakes, and household items.

Pneumococcal bacteria often cause serious illness in people of all ages:

• pneumonia;
• purulent otitis;
• meningitis, which threatens with irreversible consequences from the nervous system (15% of all brain lesions);
• pleurisy, after which encystation and adhesions of the pleura may remain; one of the most dangerous complications is empyema (bacterial infection of the pleural “leaves” with the accumulation of pus in the cavity);
• endocarditis: inflammation of the membranes of the heart, which has serious cardiovascular complications;
• arthritis with joint damage and dysfunction;
• sepsis: severe damage to the blood, all organs and systems.

The bacterium is also insidious in that it can “live” in the body, being on the mucous membrane of the “host” and without causing any harm to it. At the same time, he will not even suspect her presence. In this case, this individual will be a carrier. However, during communication, it can infect people with reduced immunity.

According to statistics, pneumococcal infection persists in approximately 60% of the population. At the same time, they can infect, but they themselves do not get sick. This means that not a single child or adult who visits crowded places, kindergarten, school, or work is immune from encountering pneumococcal infection. Pneumococcus is present everywhere, and the only way to protect yourself from it is through the Pneumo 23 vaccination.

Vaccination Pneumo 23, instructions for use (Method and dosage)

The instructions for Pneumo 23 stipulate that the vaccine is used parenterally. This solution must be administered directly from the syringe in which the product is packaged by the manufacturer.

The drug is administered subcutaneously or intramuscularly. Please note that it cannot be administered intravenously.

It is imperative that this vaccine is administered in a specialized medical facility by a qualified specialist.

Before receiving a dose of the vaccine, the patient must be examined by a specialist. If a person has a feeling of general weakness, hyperthermia, or exacerbation of chronic diseases, vaccination should be postponed.

After the drug has been administered, the person must remain under the supervision of a specialist for 30 minutes. If he develops anaphylactoid reactions, the patient is given emergency treatment.

The general scheme for using the vaccine is determined by the doctor. As a rule, during the first vaccination, one dose (0.5 ml) of Pneumo 23 is administered.

Revaccination is advisable after at least three years. When revaccinating, a person should also receive one dose (0.5 ml) of the product.

The permissible interval (three years) between the administration of Pneumo 23 can be reduced for people who have an increased likelihood of developing pneumococcal infection, as well as for those who have recently received immunosuppressive therapy.

Description of the drug

The drug is released in the form of a solution for injection in doses of 0.5 ml. Each contains a mixture of 23 common serotypes of Streptococcus pneumoniae that cause streptococcal infections.

Active ingredients:

• 
  polysaccharides (serotypes) 1, 2, 3, 4, 5, 8, 14, 20;

• 6V, 15V;
• 7F, 12F, 17F, 19F, 22F, 23F, 33F;
• 9N;
• 9V;
• 10A, 11A, 19A;
• 18C.

A colorless, transparent liquid contains 25 mcg of each.

Excipients: sodium chloride, dibasic sodium phosphate, phenol, water for injection.

The vaccine is produced using technology developed by the international pharmaceutical company Sanofi Pasteur, France.

special instructions

This vaccine is especially indicated for people who suffer from sickle cell anemia , as well as people with asplenia ; those who have recently had a splenectomy or people who are about to undergo a splenectomy.

It should be noted that if revaccination is carried out earlier than the required period, the person may experience severe local side effects after the injection.

Since there is a possibility of severe side effects (in particular, the Arthus phenomenon), before administering the drug, you need to evaluate the benefits of vaccination and take into account all contraindications.

If a person is receiving immunosuppressive treatment, the immune response to Pneumo 23 may be suppressed.

One dose of the vaccine provides effective protection.

Side effects

All immunological drugs carry an increased risk of adverse reactions and complications. Even if vaccination is carried out correctly, taking into account all the characteristics of the patient’s body, there remains the possibility that some side effect may occur.

Vaccine vaccination may be complicated by the following pathological conditions:

• Local reactions in the place where the injection was made. The skin may become red, swollen, hard, and even painful. These manifestations do not require any treatment if they are independently reduced within a few days.
• The appearance of general intoxication symptoms in the form of increased body temperature (sometimes to very high values), the appearance of increased fatigue, weakness and a significant decrease in performance. If these symptoms greatly disturb the patient’s well-being, then symptomatic treatment may be prescribed, but no specific therapy is required in this case.
• Allergic reactions of varying severity, ranging from the mildest (exanthema, enanthema, itching) to severe, even life-threatening (shock conditions, angioedema angioedema with the development of obstruction of the upper respiratory tract due to edema, bronchospastic conditions manifested by a sharp attack of suffocation) .

Pneumovax 23 and Pneumo 23: what are the differences

In our country, the drug Pneumo 23 is more common, since our doctors have been accustomed to working with it for many years.

Pneumo 23 or Prevenar: which is better?

The main difference between the Prevenar vaccine is that it is a vaccination drug for children, that is, it is not used to immunize adults. Even very young children can begin vaccination with Prevenar (from 2 months), while Pneumo 23 is indicated only from the age of two. Prevenar contains fewer types of pneumococcal infectious agents (13 serotypes) than Pneumo 23 (27 serotypes), which makes it safer for use in young children.

Prevenar should be administered three times with a one-month interval between injections, and Pneumo 23 does not require such frequent revaccination (in some cases, repeat vaccinations are not needed at all).

At the moment, the Prevenar vaccine has become more widespread in the world, but Pneumo 23 is also beginning to gain more popularity.

Analogs

Level 4 ATX code matches:
Prevenar

Analogues of this vaccine are the drugs Prevenar , Prevenar 13 .

Only a doctor can choose the most optimal remedy after an individual consultation.

Prevenar 13 or Pneumo 23 - which vaccine is better?

The Prevenar 13 vaccine contains fewer serotypes than Pneumo 23. But reviews often contain information that when using Prevenar, local side effects occur more often.

At the same time, Prevenar 13, unlike Pneumo 23, can be administered to children up to two years of age. The attending pediatrician will tell you which vaccine is best to use to immunize a child.

The advisability of using these vaccines is described in more detail by specialists, for example, Dr. Komarovsky.

Analogues of the drug

In addition to Pneumo 23, several other effective vaccines against pneumococcal infection are known in the world.
Prevenar is a drug produced in the UK. It contains 13 strains of pneumococcus. The vaccine is registered in 90 countries. It is administered to children from six months to 2 years.

Synflorix is ​​a Belgian drug. It contains 10 strains of bacteria. It has been used in the world for no more than 5 years.

During pregnancy and lactation

during the first and second trimesters of pregnancy . But if there are serious indications, immunization can be carried out in the third trimester of pregnancy under the close supervision of a doctor.

If a pregnant woman has been vaccinated, after administering the drug she should be under the supervision of a doctor for at least three hours.

Vaccination during lactation is acceptable. There is no need to interrupt breastfeeding.

In what cases is vaccination contraindicated?

Such cases, of course, also exist. However, the question of the possibility of carrying out is always decided individually with each patient, depending on the type of pathology, its severity, age, concomitant diseases, etc.

There are absolute and relative contraindications.

Absolute is the presence of intolerance to one or more components of the drug. Administration of the drug can cause an allergic reaction, including angioedema or anaphylactic shock. In this case, we will not help the body fight the virus, but on the contrary, we will cause irreparable harm to it.

The following should be considered relative:

• increased body temperature from 37.5 degrees and above;
• acute period of any disease;
• chronic diseases in the acute stage;
• the first six months of pregnancy.

Note. Some people assume that if they have recently had pneumonia, their body has developed immunity. But this is a mistaken opinion. Protection, if formed, is from 2 or 3 types of pathogen. Vaccination provides a guarantee against 23 serotypes of pneumococcal infection.

You should always remember that restrictions for pregnant women exist only in the first two trimesters, and the issue of injection is decided separately with each patient after a detailed examination. In the third trimester, vaccination is already allowed. This will not harm either the mother or the unborn child.

Reviews about Pneumo 23

There are often opinions on the Internet about how effective the Pneumo 23 vaccination is. There are various reviews. Many parents write that after vaccination, the child began to suffer from infectious diseases much less. After vaccination, the diseases disappear quickly, without significant complications. It is important to vaccinate correctly and follow all doctor's advice.

Side effects are rarely mentioned in reviews; local manifestations are mainly noted, which quickly disappear. When discussing how effective the Pneumo 23 vaccine is, reviews from doctors are mostly positive.

The famous pediatrician Komarovsky, as well as other doctors, recommend vaccination to prevent the development of diseases.

What complications and adverse reactions does Pneumo 23 cause?

As a rule, there are no serious deviations in health or undesirable consequences after vaccination. There is a tiny percentage of people with a strong allergic reaction to the drug.

Local allergies usually occur in the form of local redness of the skin, slight swelling and slight pain. Sometimes there is a rise in temperature to subfebrile levels, which is controlled by taking antipyretic medications (if necessary). Additional treatment of the injection site is usually not required.

More serious reactions include:

• the appearance of skin rashes on the body;
• lymphadenitis;
• anaphylaxis.

In the unlikely event of general reactions, seek immediate medical attention. In most cases, when there is still a threat to the life and health of the patient, they use.

To avoid unforeseen situations and dangerous side effects, you should contact only qualified specialists and perform the procedure after a thorough examination and clarification of complaints and allergic history.