From the Guidelines
A 2-month-old infant should receive the pneumococcal conjugate vaccine PCV13, not PCV15 or PCV23, as PCV13 is the recommended vaccine for this age group. The recommended schedule for pneumococcal vaccination in infants begins at 2 months of age with additional doses at 4 months, 6 months, and 12-15 months 1. PCV13 is appropriate for this age group as it stimulates an immune response even in young infants by conjugating the pneumococcal polysaccharides to a protein carrier.
Some key points to consider:
- The conjugate vaccines, such as PCV13, provide protection against the most common pneumococcal serotypes that cause invasive disease in children, including meningitis, bacteremia, and pneumonia 1.
- PCV13 is recommended as a 4-dose series at ages 2,4,6, and 12–15 months 1.
- The vaccine is administered as a 0.5 mL intramuscular injection, typically in the anterolateral thigh muscle for infants.
- PPSV23 is not recommended for children under 2 years of age because it contains only polysaccharide antigens which don't effectively stimulate the immature immune system of infants 1.
It's worth noting that while PCV15 and PCV20 are not mentioned in the provided evidence, PCV13 is the recommended vaccine for infants aged 2 months, and it's essential to follow the recommended schedule to ensure optimal protection against pneumococcal disease 1.
From the Research
Pneumococcal Conjugate Vaccine (PCV) for 2-Month-Old Infants
- The pneumococcal conjugate vaccine is recommended for infants and children under 24 months of age to prevent invasive pneumococcal disease, pneumonia, and otitis media 2.
- A 2-month-old infant can receive the pneumococcal conjugate vaccine, with the first dose given as early as 6 weeks of age 2.
PCV15 and PCV23 for 2-Month-Old Infants
- PCV15 is a 15-valent pneumococcal conjugate vaccine that has been approved for use in individuals ≥6 weeks of age for the prevention of pneumonia, acute otitis media, and invasive pneumococcal disease 3.
- PCV23 is a 23-valent pneumococcal polysaccharide vaccine that is not recommended for infants under 2 years of age due to the immaturity of the T-cell independent immune function 2.
- However, PCV15 can be given to 2-month-old infants, and it is recommended as an option for pneumococcal conjugate vaccination of persons aged <19 years according to currently recommended PCV13 dosing and schedules 4.
Safety and Immunogenicity of PCV15 in Infants
- Studies have shown that PCV15 is safe and immunogenic in infants, with a safety profile comparable to PCV13 5, 3.
- PCV15 has been shown to elicit higher antibody responses to serotypes 22F and 33F, which are unique to the vaccine, and serotype 3, for which PCV13 has been shown to be ineffective 5, 3.
Recommendations for PCV15 Use in Infants
- The Advisory Committee on Immunization Practices (ACIP) recommends use of PCV15 as an option for pneumococcal conjugate vaccination of persons aged <19 years according to currently recommended PCV13 dosing and schedules 4.
- The ACIP recommends that infants receive the vaccine routinely at 2,4, and 6 months with a fourth dose at 12 to 15 months of age 2, 4.