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Prevnar - the ear infection vaccine?

The pneumococcus is a bacteria that causes serious infections in adults and children, including pneumonia, blood infections, and meningitis. This bacteria is also the number one cause of sinusitis and ear infections. Pneumovax, the 23-valent pneumococcal polysaccharide vaccine (23PS) protects against many different types of the pneumococcus bacteria and it is recommended that it be given to adults over age 65 and children over age two who are at high risk.

Unfortunately, 23PS does not provide protection for children under age two, but another version of the vaccine, Prevnar, or heptavalent pneumococcal conjugate vaccine (PCV7), has been available for some time and can be given to younger children. It was approved by the FDA in February 2000. Prevnar protects against the seven most common strains of Pneumococcus that cause invasive disease, including bloodstream infections and meningitis.

Prevnar may also reduce the number of ear infections a child has in children with a history of recurrent ear infections. Although often though of by parents as the ear infection vaccine, it is not yet approved by the FDA for this indication. It is estimated that children with recurrent ear infections who are vaccinated will have about a 10%-20% lower chance of having recurrent ear infections or tube placement.

Prevnar is given as a four dose series, starting at two months of age (with a minimum of 6 weeks of age). Subsequent doses are given at age four months and six months of age, with a fourth dose at age 12-15 months (and at least two months after the third dose). It is recommended that all children under age 23 months be given this vaccine.

The American Academy of Pediatrics recommendations for the prevention of pneumococcal infections with Prevnar includes the routine use of Prevnar for all children 23 months and younger, and for children aged 24-59 months who are at high risk, including children with an immune deficiency, sickle cell disease, asplenia (children without a working spleen), HIV infection, chronic cardiac conditions, chronic lung problems (including asthma), cerebrospinal fluid leaks, chronic renal insufficiency (including nephrotic syndrome) , diabetes mellitus, and children who are receiving immunosuppresive therapy (organ transplants, etc.). The AAP does not recommend routine use in children who are only at moderate risk of infection, including all children aged 24-35 months old, and children aged 36-59 months who attend daycare or who are of Native-American, Alaskan-native, or African-American descent.

Children aged 24-59 months who have already received a dose of 23PS and who are at high risk should also receive 2 doses of Prevnar at least 6-8 weeks later and a second dose of 23PS in 3-5 years. High risk children who have completed the Prevnar series should also receive a dose of 23PS at 24 months of age.

Although not recommended routinely, all children aged 24-59 months may receive one dose of either the 23PS or Prevnar vaccine if desired.

Although it is approved for use up to age 9, it is recommended that Prevnar not be routinely given to children over 5 years old. The risk of invasive infection with the pneumococcus bacteria is much less in children over age 5. However, if desired, high risk children can receive either the older 23PS vaccine, which is cheaper, provides good coverage against 23 subtypes of the pneumococcus and produces a good antibody response in children of this age, or they can receive the newer vaccine.

The most common adverse effects of Prevnar include injection site reactions, fever, irritability, drowsiness, restless sleep, and decreased appetite.

Prevnar Links:

  • Prevnar.com: the manufactures homepage, with information for parents and pediatricians.
  • Vaccine Information Statements - download the current Prevnar (Pneumococcal Conjugate) VIS, which is distributed by the US Center for Disease Control and which are required to be given to parents before a vaccine is administered to your child.

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