PCV13 is Recommended for 2-Month-Old Infants
A 2-month-old infant should receive the 13-valent pneumococcal conjugate vaccine (PCV13) as the first dose in a recommended 4-dose series. 1
Vaccination Schedule for PCV13
The Advisory Committee on Immunization Practices (ACIP) recommends PCV13 for all children starting at 2 months of age, with the following schedule:
- Primary infant series: 3 doses at 2,4, and 6 months of age
- Booster dose: 1 dose at 12-15 months of age
For infants beginning vaccination at 2 months of age, the doses should be administered with intervals of approximately 8 weeks between doses (minimum interval is 4 weeks). 1
Administration Details
- The first dose can be administered as early as 6 weeks of age, but the recommended age to begin is 2 months 1
- For premature infants who are medically stable, PCV13 should be administered at the recommended chronologic age along with other routine vaccinations 1
- PCV13 can be administered concurrently with other routine childhood vaccines at different injection sites 1, 2
Importance of PCV13
PCV13 provides protection against 13 serotypes of Streptococcus pneumoniae that can cause invasive pneumococcal disease, pneumonia, and otitis media. The vaccine contains serotypes 1,3,4,5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, and 23F polysaccharides individually conjugated to CRM197 protein. 3, 4
Immunogenicity and Efficacy
Studies have demonstrated that PCV13 is highly immunogenic after the primary infant series:
- After 2 doses, >85% of infants achieve protective antibody levels (≥0.35 μg/mL) for most serotypes 5
- Some serotypes, particularly 6B and 23F, may have lower response rates after just 2 doses (27.9-81.4% and 55.8-77.5%, respectively) 5
- The full 3-dose primary series improves immune response to all serotypes 6
- The booster dose at 12-15 months significantly enhances antibody levels and provides longer-lasting protection 7
Special Considerations
For children who previously received PCV7 (the earlier 7-valent vaccine), they should complete their series with PCV13 to gain protection against the additional serotypes. 1, 8
Common Pitfalls to Avoid
- Delaying vaccination: Starting the PCV13 series at 2 months is crucial for timely protection against pneumococcal disease
- Incorrect intervals: Maintaining the recommended 8-week intervals between doses ensures optimal immune response
- Incomplete series: Completing all 4 doses is essential for full protection, particularly for serotypes that require multiple doses to achieve protective immunity
- Not adjusting for missed doses: If doses are missed, the vaccination schedule should be continued without restarting the entire series 1
PCV13 has replaced the earlier PCV7 formulation and provides broader protection against pneumococcal disease, which is particularly important for young infants who are at higher risk for invasive pneumococcal infections.