The National Advisory Committee on Immunization (NACI) provides vaccination recommendations for Canadians. Each province considers these recommendations and its budget to decide which vaccines will be publicly funded. Part of the decision process is considering which population members are at greatest risk of a particular infection. Pneumococcal vaccination has been available through public health for adults of any age who are compromised adults based on condition or treatment along with all adults age 65 and older. Pneumococcal vaccination is also part of the childhood immunization schedule.
In the newest guidelines, the two pneumonia vaccines approved by Health Canada that offer the greatest protection are Prevnar 20 by Pfizer and Capvaxive by Merck. In a previous blog post, we mentioned that Capvaxive offered 8 different strains compared to Prevnar 20 and that these strains were more prevalent in adults hospitalized with pneumonia. Since 2019, there has been a shift in the most prevalent pneumonia strains. This means that the overall protection, although slightly different between vaccines, is just over 70% regardless of which vaccine is used, resulting in an equal recommendation to receive either vaccine. In Ontario, Prevnar 20 is the only one funded for adults through public health and supplied to family doctor’s offices.
If you had a different pneumonia vaccine in the past, such as Prevnar 13 or Pneumovax, then it is suggested you wait one year since the older vaccine was given to upgrade to Prevnar 20 or Capvaxive. If someone is going on highly compromising therapy and the update is required sooner, Prevnar 20 or Capvaxive should be given a minimum of eight weeks after a previous older vaccine. Should you have received either of the newer vaccines, no booster dose is suggested. Of course, with research and new vaccines always on the horizon, this guidance may continue to change.
Carolyn Whiskin is the Pharmacy Manager for Charlton Health. Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain, and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.
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