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PPV23 shortage: recommendations on managing immunisation in 2018

Takeaway

  • As pneumococcal polysaccharide vaccine (PPV23) shortage continues, Public Health England (PHE) has recommended realigning vaccination practice to ensure appropriate use of available stock and consistent demand for the vaccine throughout the year.

PHE has notified that the supply constraints affecting the PPV23 are likely to continue for the foreseeable future. To tackle this issue, PHE has recommended offering PPV23 to those eligible throughout the whole of 2018, rather than aligning it parallel to the influenza programme.

Although the eligibility for PPV23 remains the same, priority groups have been defined based on the clinical risk. The high priority group includes those with asplenia/spleen dysfunction, immunosuppression, cerebrospinal fluid leaks and cochlear implants. The moderate priority group includes those with diabetes and chronic diseases of the lungs, heart, kidney and liver. Low priority group includes healthy adults aged ≥65 years.

PHE has advised healthcare professionals that as and when PPV23 stocks are available, the priority for vaccination should be given to the high and moderate priority groups. Opportunistic immunisation of high and moderate priority individuals not previously vaccinated, and booster doses for those with splenic dysfunction and chronic kidney disease takes a lower priority and can be scheduled when adequate stock is available.

PHE has warned that national stocks of pneumococcal conjugate vaccine (PCV13; Prevenar13) or PCV10 (Synflorix) are not to be used as alternatives to PPV23. The elderly are likely to have developed herd immunity against 13 (or 10) serotypes owing to the infant and toddler vaccination programme. In such a scenario, only PPV23 can provide protection against the serotypes predominant in that age group.


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