The change over

Prevenar13® (PCV13) provides broader protection than Synflorix® (PCV10)

There has been an increase in pneumococcal serotype 19A notifications in New Zealand, as a result, PHARMAC has decided to fund access to Prevenar13® (PCV13), which protects against three additional serotypes (3,6A and 19A) that are not covered by Synflorix® (PCV10).

PCV13 will be funded from 1 December 2022

Date of the change over is 1 December 2022. PCV13 is not funded before 1 December, but is from 1 December onwards. No PCV10 should be used after 30 November, unless your supply of PCV13 has not yet arrived.

 Supply issues

• If you have noPCV13 then offer people the option: use PCV10 now or come back when you have PCV13.
• If you have somePCV13 but not enough for all: prioritise PCV13 for tamariki on the high risk pneumococcal programme.
• If you have PCV13 for all, use it. 
• Earlier statements about not using PCV10 from 1 December are superseded by this guidance ie it is not considered an error to administer it. Note also that you will be paid for administering PCV10.

Timing and doses

Dose timing remains the same

PCV13should be administered at:

·      6 weeks (all)

·      3 months (high risk only)

·      5 months (all)

·      12 months (all). 

If started with PCV10, continue course with PCV13

If PCV10 has been given at 6-week and/or 5 month milestone, the next pneumococcal vaccination/s would be PCV13 instead of PCV10. 

PCV10 full course, no catch up of additional PCV13 at this stage

Children who have were previously vaccinated with a full course of PCV10 do not need PCV13. However, PHARMAC is seeking further clinical advice on a proposal for a catch-up programme. 

Tāmariki aged under 5 years may be eligible for catch up of PCV13

If a course of PCV10 has not been completed, children under 5 years will be eligible for catch up doses. Consult with 0800 IMMUNE or refer to Appendix 2 of Immunisation Handbook for information on appropriate catch-up doses.

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High risk vaccinee

Criteria for high risk remain the same

There is no change to the criteria used to confirm who is deemed to be at ‘high risk’ of pneumococcal disease (see the PHARMAC schedule). Those who meet the criteria should have include the extra primary course dose administered at 3 months of age. Thus, they receive 4 doses in total (3+1schedule).

23PPV only follows for high risk

It is important for all of those who are considered to be ‘high risk’ of pneumococcal disease continue to receive their 23PPV from aged 2 years.

Table 1: Catch-up for PCV13 Immunisation

Please see the image below of this web page for reference.

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Errors and ordering

Using PCV10 after 1 December, if you have PCV13for all, is a medication error

Please contact 0800 IMMUNE to discuss each case for specific advice and follow usual medication error processes. PCV10 would still be funded if administered but clinical advice should still be sought regarding revaccination to ensure best protection for the child. 

If your practice runs out of PCV10 before 1 December – get more PCV10

If a provider runs out of PCV10 before 1December 2022, they will need to obtain more PCV10. Providers should have a minimum of two weeks stock available at any one time. PCV13 for tāmariki not classified as high-risk, is only funded from 1 December 2022.

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Logistics

Single or ten dose packs available

PHARMAC has advised that PCV13 stock may initially arrive in either single dose packs or 10 dose packs, so take particular care when ordering stock as to what box size is available, and what fridge capacity is available. 

Excess PCV10 stock needs to be returned after 30 November 2022

PCV10 stock is not to be used after 30 November 2022.Excess stock should be returned to ProPharma for destruction. These packs can be placed inside the returnable ProPharma boxes that are used to deliver vaccine orders to your practice. 

Full instructions for that return process are printed on the outside of the shipping carton. If that is not practical, then stock can also be sent back in separate parcels that are labelled with a Vaccines For Destruction label; these labels are available under the ‘Resources’ section of www.fundedvaccines.co.nz. Call the phone number on this label to arrange collection by a courier.

PCV13 stock can be ordered from 21 November 2022

Check ProPharma website for updates if available earlier depending on stock arrival to warehouse. Backorders of PCV13 will not be released.

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Schedule

CALL 0800 IMMUNE (466 863) for clinical advice