What are the recommendations for administering Prevnar 13 (Pneumococcal conjugate vaccine)?

Prevnar 13 (PCV13) Administration Recommendations

Prevnar 13 (PCV13) is recommended as a 4-dose series at ages 2,4,6, and 12-15 months for all children, with specific catch-up schedules based on age and previous vaccination history. 1

Routine Vaccination Schedule for Children

Infants Aged 2-6 Months

• Primary series: 3 doses of PCV13 at approximately 8-week intervals (minimum 4 weeks)
• First dose can be administered as early as 6 weeks of age
• Fourth (booster) dose at 12-15 months, at least 8 weeks after third dose
• Premature infants should follow the same chronologic age schedule if medically stable 1

Children Aged 7-11 Months (Previously Unvaccinated)

• 2 doses at least 4 weeks apart
• Third dose at 12-15 months, at least 8 weeks after second dose 1

Children Aged 12-23 Months (Previously Unvaccinated)

• 2 doses with at least 8 weeks between doses 1

Children Aged 24-59 Months (Previously Unvaccinated)

• Healthy children: Single dose of PCV13
• Children with underlying medical conditions: 2 doses of PCV13 with at least 8 weeks between doses 1

Children Aged 60-71 Months (Previously Unvaccinated)

• Only children with underlying medical conditions: 2 doses of PCV13 with at least 8 weeks between doses 1

Catch-up Vaccination for Children with Incomplete Schedules

Children <24 Months with Prior PCV7/PCV13 Doses

• Complete the series with PCV13
• Children 12-23 months who received 3 doses of PCV7 before age 12 months: 1 additional dose of PCV13 at least 8 weeks after most recent dose
• No additional PCV13 doses needed for children 12-23 months who received 2-3 doses of PCV7 before 12 months AND at least 1 dose of PCV13 at ≥12 months 1

Children ≥24 Months with Incomplete Vaccination

• Healthy children 24-59 months: 1 dose of PCV13 to complete schedule
• Children 24-71 months with underlying medical conditions who received <3 doses before 24 months: 2 doses of PCV13 with at least 8 weeks between doses 1

Special Considerations

Children with High-Risk Conditions

• Children with immunocompromising conditions, functional/anatomic asplenia, cerebrospinal fluid leaks, or cochlear implants should receive both PCV13 and PPSV23
• PPSV23 should be administered to high-risk children aged 2-18 years after completing all recommended doses of PCV13 2

Interrupted Vaccination Schedule

• If vaccination schedule is interrupted, it does not require restarting the entire series
• Continue from where the schedule was interrupted, following age-appropriate recommendations 1

Common Pitfalls and Caveats

1. Mixing vaccine types: When transitioning from PCV7 to PCV13, follow specific recommendations for completing the series with PCV13 1

2. Interval timing: Minimum interval between doses is 4 weeks for primary series and 8 weeks for the booster dose - shorter intervals may result in suboptimal immune response 1

3. Age-specific dosing: Number of doses varies by age at first vaccination - don't give unnecessary doses or miss required doses 1

4. High-risk conditions: Children with certain medical conditions require additional consideration for PPSV23 after PCV13 series 2

5. Premature infants: Should receive PCV13 at the same chronologic age as term infants, not adjusted age 1

The evidence strongly supports the effectiveness of PCV13 in preventing invasive pneumococcal disease, with clinical trials demonstrating significant reduction in pneumococcal disease burden 3. Following these specific administration guidelines ensures optimal protection against pneumococcal infections.