Pneumovax 23 is a 23-valent polysaccharide vaccine containing 23 purified capsular antigens of Streptococcus pneumoniae serotypes 1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F, and 33F. This includes the six serotypes that most frequently cause invasive drug-resistant pneumococcal infections among children and adults in the US. In the US and EU, the vaccine is approved for the prevention of pneumococcal disease in adults aged 50 years and older, and in children aged two years and older who are at increased risk of pneumococcal disease.
Since a significant decline in 2015, largely due to its relegation to a niche as a booster vaccine in high-risk children and the elderly,
Pneumovax 23’s (23-valent pneumococcal polysaccharide vaccine [PPV]; Merck & Co) US sales have experienced steady growth driven
by price rises in the US and population growth. Despite being the marketed vaccine that covers the most serotypes, Pneumovax 23’s
uptake has been limited by hyporesponsiveness, which limits the possibility for revaccination, as well as controversy surrounding its
ability to prevent pneumococcal disease, specifically pneumonia, in both children and adults. Pneumovax 23’s recommended patient
population is limited to children and adults over the age of two years who are at increased risk for pneumococcal disease, and all
adults aged 65 years and older, where it is indicated as a single-dose booster vaccine. It remains a recommended booster dose
following a primary dose of Prevnar 13 (13-valent pneumococcal conjugate vaccine; Pfizer) for high-risk individuals due to its ability to
provide broader protection than Prevnar 13 alone, as well as its position as the only polysaccharide vaccine on the market. However,
this patient population is relatively small and thus offers less commercial potential than if it were recommended as a primary dose in
infants (where three to four doses of Prevnar 13 are recommended).
LIST OF FIGURES
12 Figure 1: Pneumovax 23 sales for pneumococcal vaccination across the US, Japan, and five major EU markets, by country, 2017–26
LIST OF TABLES
6 Table 1: Pneumovax 23 drug profile
7 Table 2: Approval history of Pneumovax 23 for pneumococcal vaccination in the US, Japan, and five major EU markets
7 Table 3: Pneumococcal vaccine recommendations for Pneumovax 23, by country and age group
8 Table 4: Late-phase trials of Pneumovax 23 for pneumococcal vaccination
9 Table 5: Pneumovax 23 for pneumococcal vaccination – SWOT analysis
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