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Pneumococcal vaccine: choose on the basis of the child's age

There have been reports in France of infants receiving unconjugated pneumococcal polysaccharide vaccine (Pneumovax°), which is ineffective at this age, instead of the pneumococcal conjugate vaccine (Prevenar°), as a result of prescribing or dispensing errors.

Infants occasionally receive unconjugated pneumococcal polysaccharide vaccine (Pneumovax°) instead of a conjugate vaccine (Prevenar°). But the unconjugated vaccine is only weakly immunogenic, and therefore unprotective, in children under the age of 2 years.

The causes of these errors include: unconjugated vaccines having more explicit brand names than the conjugate vaccine; lack of awareness of the differences in efficacy between the two types of vaccine in childhood, which is why their vaccination schedules differ; and insufficiently informative labelling.

Pharmaceutical companies should warn users about the risk of confusing conjugated vaccines with unconjugated vaccines by displaying this information very prominently on the box, patient leaflet and syringe label, designed to be detached and affixed to the patient's immunisation records and checked before administration.

To prevent these errors, it is important to check at every stage of the vaccination process that the type of pneumococcal vaccine is appropriate for the child's age, especially when selecting the vaccine by name from an electronic system. It is prudent not to rely on the brand name alone, but to refer to these pneumococcal vaccines by their common name first, always specifying "conjugate" or "unconjugated" , and ensuring that the prescription includes the child's age.

©Prescrire 1 February 2022

Source: "Pneumococcal vaccine errors: infants poorly protected" Prescrire International 2022; 31 (234): 48-49. Subscribers only.

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See also:
"Vaccination-related errors:
analysing errors in order
to prevent them"
(September 2017)
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