Singapore is the first nation in Asia to receive the new pneumococcal vaccine.
Seniors are advised to receive the PCV13 vaccine first, followed by the PPSV23 vaccine one year later.
SINGAPORE – Singapore will be the first Asian nation to receive Pfizer’s new pneumococcal vaccine, which offers a broader range of protection and could replace the two vaccines currently in use.
The vaccines provide protection against the more prevalent bacterial strains that cause pneumococcal disease, which causes a variety of infections, including pneumonia, meningitis, sinusitis, and middle-ear infection. It can result in extremely serious illness and even death.
In fact, pneumonia, or lung inflammation, is the third leading cause of death in this region.
These vaccines do not protect against all causes of pneumonia, which can be caused by a variety of microorganisms, such as other types of bacteria, viruses, and fungi.
However, they do provide protection against the more prevalent strains of the Streptococcus pneumoniae bacteria, which is why the government encourages and subsidizes pneumococcal vaccination for Singaporean children and the elderly.
Seniors are advised to receive the pneumococcal conjugate PCV13 vaccine first, followed a year later by the pneumococcal polysaccharide PPSV23 vaccine.
PCV20 protects against seven additional bacterial strains than PCV13, which was also manufactured by Pfizer. Merck Sharp & Dohme’s PPSV23 covers 23 different bacterial strains.
Professor Julio Ramirez, chief research scientist at the Norton Infectious Diseases Institute at Norton Healthcare in the United States and principal investigator in PCV13 vaccine studies, was brought in by Pfizer for the Saturday launch of the PCV20 vaccine.
In contrast to polysaccharide vaccines, conjugate vaccines prime T cells and memory B cells, allowing them to mount a response against invasive bacteria even after the level of antibodies has diminished.
Professor Ooi Eng Eong, a microbiologist at the Duke-NUS Medical School, remarked that the immune responses elicited by a conjugate vaccine “would theoretically be broader and more durable than those induced by polysaccharides alone.”
Associate Professor Lim Poh Lian, who directs the Travellers’ Health and Vaccination Clinic at Tan Tock Seng Hospital and is a senior consultant at the National Centre for Infectious Diseases, stated, “Conjugate vaccines like PCV13 or PCV20 are better able to stimulate an immune response than the polysaccharide vaccine PPSV23. This is the reason conjugate vaccines were developed.”
Associate Professor Hsu Liyang, an expert in infectious diseases at the National University of Singapore Saw Swee Hock School of Public Health, asserts that the newer vaccine can unquestionably replace PCV13.
“It is also possible that this vaccine could eliminate the need for the 23-valent polysaccharide vaccine,” he continued.
Prof. Lim concurred, stating, “For those who have not yet received the PCV13 and PPSV23 combination, a single dose of PCV20 simplifies the vaccination schedule for patients and their families.” Instead of trying to coordinate two vaccinations with all of their other medical appointments, this vaccine enables them to get “one and done.”
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While Dr. Asok Kurup, chair of the Chapter of Infectious Disease Physicians, agrees that the broader coverage of PCV20 can mean a single dose for the vast majority, he recommends that those at a higher risk, such as the immunocompromised, receive PPSV23 as well because it protects against more strains.
The Ministry of Health (MOH) informed The Straits Times that, although the new vaccine has been approved for use in Singapore since November 2022, a review is currently underway to determine “whether the vaccine should be recommended for inclusion in the national immunisation schedules.”
If not, there will be no subsidy for its utilization.
Prof. Lim stated that the Expert Committee on Immunisation is evaluating the clinical- and cost-effectiveness of PCV20 and its optimal application.
Dr. Kurup stated that the PPSV23 costs just under $100 and the PCV13 approximately $200 in the private sector. He added that the price of PCV20 should be comparable to that of PCV13.
A spokesperson for the Department of Health advised those who have been advised to receive the PCV13 and PPSV vaccines under the National Adult Immunisation Schedule to do so. Currently, the PCV20 is not intended for use in children.
People who have received the two pneumococcal vaccines do not require the PCV20, according to the infectious disease specialists with whom ST spoke.
Professor Paul Tambyah, a senior infectious diseases consultant at the National University Hospital, stated, “The most important question is whether PCV20 will be replaced by PCV25.”
A study for a 25-valent pneumococcal conjugate vaccine that began in 2022 is anticipated to conclude in 2025.
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