Wednesday, January 4, 2012

Old Vaccine for a New Population: Prevnar 13

Good news.

I pasted this article from a link sent by Therapeutic Daily about approval of "kid's" vaccine for adults over 50.

This news is about the conjugated form of the pneumococcal vaccine that kids have been getting for years. Protein conjugated vaccines such as Prevnar are better at eliciting an immune response than the wimpy antigenic stimulation of a polysaccharide vaccine such as Pneumovax that until recently was the only FDA choice for adults. Moreover, protection against 13 subtypes of this potentially lethal bacteria in those with compromised immunity is better than the old Prevnar 7 but still not up to the high water mark of Pneumovax 23. More quantity, less quality.

So if we are early in your CLL, and haven't had recent rituximab or chemo, we should ask our doctor about it. The longer we wait, and the more immune damaging drugs that have hit our veins, the less likely of any meaningful response. Still, the risks are low, though the timing of boosters can be tricky and the small but real chance of untoward reactions are issues best discussed with our local providers.
More importantly, suggest that appropriate family members and friends do the same. See my recent post about the importance of herd immunity.
Remember that the leading cause of death in CLL is infections.
The leading infection is pneumonia.
The leading bacteria that causes pneumonia is what old school doctors like me called pneumococcus, but now more commonly answers to streptococcus pneumoniae. This invader can also cause a host of other infections including meningitis and sepsis.

This vaccine offers an extra modicum of protection and for that I am grateful.

I have been suggested the off label use of this vaccine for years in adults, Now the FDA has caught up so it should be less of a stretch for a primary care provider to OK the shot.
Here's the pasted text:

FDA Approves Pneumococcal 13 Vaccine

From the News Archive - Dec. 31, 2011

From UPI Health News (Business) (December 31, 2011)

Prevnar 13, a pneumococcal 13 vaccine, was approved by the U.S. Food and Drug Administration for people age 50 and older to prevent pneumonia, officials said.

Dr. Karen Midthun, director of U.S. Food and Drug Administration's Center for Biologics Evaluation and Research, said pneumococcal pneumonia, caused when the bacterium Streptococcus pneumoniae infects the lungs, is the most common disease caused by this bacterium in adults.

When the bacterium invades parts of the body that are normally free from germs, such as the blood or spinal fluid, the disease is considered "invasive," Midthun said.

"According to recent information for the United States, it is estimated that approximately 300,000 adults age 50 and older are hospitalized yearly because of pneumococcal pneumonia," Midthun said in a statement. "Pneumococcal disease is a substantial cause of illness and death. Today's approval provides an additional vaccine for preventing pneumococcal pneumonia and invasive disease in this age group."

The new use for Prevnar 13 was approved under the agency's accelerated approval pathway, which allows for earlier approval of treatments for serious and life-threatening illnesses, Midthun said.

The pathway allows for the demonstration of effectiveness of a vaccine using an immune marker that is reasonably likely to predict clinical benefit.

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