Prevenar 13 - instructions for use, reviews, analogues and forms of release (suspension or solution of vaccine in ampoules or syringes for injection) of a drug for the prevention of pneumococcal infection and vaccination in adults, children and during pregnancy. Composition

In this article, you can read the instructions for using the drug Prevenar 13. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of experts on the use of Prevenar in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Prevenar 13 in the presence of existing structural analogues.Use for the prevention of pneumococcal infection and vaccination in adults, children (including infants and newborns), as well as during pregnancy and lactation. Composition of the preparation.

 

Prevenar 13 - a vaccine for the prevention of pneumococcal infections.

 

Immunological properties

 

Introduction of the vaccine Prevenar 13 induces the production of antibodies to the capsular polysaccharides of Streptococcus pneumoniae (Streptococcus), thereby providing specific protection against infections caused by vaccines included in 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F and 23F serotypes of pneumococcus.

 

According to WHO recommendations for new conjugated pneumococcal vaccines, the equivalence of the immune response of Prevenar 13 was determined according to three criteria: the percentage of patients who reached the concentration of specific IgG antibodies more than 0.35 μg / ml; average geometric concentrations (SGC) of immunoglobulins and opsonophagocytic activity (OFA) of bactericidal antibodies (OFA titer more than 1: 8 and average geometric titres (CGT)). For adults, the protective level of anti-pneumococcal antibodies is not defined and a serotype-specific OFA (CGT) is used.

 

The Prevenar 13 vaccine includes up to 90% of the serotypes that cause invasive pneumococcal infections (IPI), including antibiotic-resistant ones.

 

The immune response when using three or two doses in a series of primary vaccinations

 

After administration of three doses at 13 Prevenar primary vaccination in children younger than 6 months, marked a significant rise in antibody levels to all vaccine serotypes.

 

After administration of two doses at primary vaccination Prevenar 13 within the mass vaccination of children in the same age group as there is a significant rise in antibody titers to all components of vaccines for serotypes 6B and 23F IgG level over 0.35 g / ml was determined in a smaller percentage of children. At the same time, there was a pronounced booster response to revaccination (repeated vaccination) for all serotypes. The formation of immune memory is indicated for both of the above vaccination schemes. Secondary immune response to a booster dose in the second year of life of children using three or two doses of the primary vaccination series is comparable for all 13 serotypes.

 

When vaccination premature infants (born at a gestational age less than 37 weeks), including deep preterm infants (born at a gestational age less than 28 weeks), starting at the age of two months, it was noted that the level of protective antibodies specific protivopnevmokokkovyh and after OFAof the completed vaccination course reached values ​​above protective in 87-100% vaccinated to all thirteen included in the vaccine serotypes.

 

Immunogenicity in children and adolescents aged 5 to 17 years

 

Children aged 5 to 10 years who previously received at least one dose of pneumococcal 7-valent conjugate vaccine, as well as previously unvaccinated children and adolescents aged 10 to 17 years, received one dose of Prevenar 13, demonstrated an immune response to all 13 serotypes, equivalent to that in children 12-15 months old, vaccinated with four doses of Prevenar 13.

 

One-time introduction Prevenar 13 children aged 5-17 years are able to provide the necessary immune response to all the serotypes of the pathogen that make up the vaccine.

 

Effectiveness Prevenar 13

 

Invasive pneumococcal infection (IPI)

 

After the introduction of Prevenar in the 2 + 1 regimen (two doses in the first year of life and the revaccination once in the second year of life), in four years with 94% coverage, 98% (95% CI: 95, 99) decreased the frequency of IPI caused by the vaccine- specific serotypes. After the transition to Prevenar 13, there was a further decrease in the frequency of IPI caused by vaccine-specific additional serotypes, from 76% in children under 2 years old to 91% in children aged 5-14 years.

 

Pre-venereal serotyping-specific efficacy with respect to IHI in preterm 13 children varied from 68% to 100% (serotype 3 and 6A, respectively) and was 91% for serotypes 1, 7F and 19A), while There were no cases of IPI caused by serotype 5. After the inclusion of Prevenar 13 in national immunization programs, the frequency of registration of IPI caused by serotype 3 declined by 68% (95% CI 6-89%) in children under 5 years of age. A case-control study performed in this age group showed a reduction in the incidence of IPI caused by serotype 3 by 79.5% (95% CI 30.3-94.8).

 

Otitis media (CO)

 

After the introduction of Prevenar vaccination and the subsequent transition to Prevenar 13 in the 2 + 1 regimen, the incidence of CO caused by serotypes 4, 6B, 9V, 14, 18C, 19F, 23F and serotype 6A was reduced by 95%, and a 89% CO, caused by serotypes 1, 3, 5, 7F and 19A.

 

Pneumonia

 

In the transition from Prevenar to Prevenar 13, there was a 16% reduction in the incidence of all community-acquired pneumonia (PFS) in children aged 1 month to 15 years. Cases of PLE with pleural effusion decreased by 53% (p less than 0.001), pneumococcal PFS decreased by 63% (p less than 0.001). In the second year after the introduction of Prevenar 13, a 74% reduction in the incidence of PFS caused by 6 additional serotypes of Prevenar 13 was noted.68% (95% CI: 73; 61) of outpatient visits and 32% (95% CI: 39; 22) had a reduction in hospital admissions for children under 5 years after the introduction of Prevenar 13 vaccine in a 2 + 1 schedule alveolar VBP of any etiology.

 

Carrier and Population Effect

 

The effectiveness of Prevenar 13 in reducing the carriage in the nasopharynx of vaccine-specific serotypes, as well as those of the Prevenar vaccine (4, 6B, 9V, 14, 18C, 19F, 23F) and 6 additional (1, 3, 5, 6A, 7A , 19A) and related serotype 6C.

 

The population effect (a serotype-specific reduction in the incidence of unvaccinated individuals) has been noted in countries where Prevenar 13 has been used as part of mass immunization for more than 3 years, with high vaccination coverage and compliance with the immunization schedule. In unvaccinated Prevenar, 13 individuals 65 years of age and older have experienced a 25% reduction in IPI, while FTIs caused by serotypes 4, 6B, 9V, 14, 18C, 19F, 23F have decreased by 89% and 64% decreased IPI due to 6 additional serotypes (1, 3, 5, 6A, 7A, 19A). The incidence of infections caused by serotype 3 decreased by 44%, serotype 6A - by 95%, serotype 19A - by 65%.

 

Immunogenicity of Prevenar 13 in adults

 

Clinical studies of Prevenar 13 provide data on immunogenicity in adults 18 years of age and older, including those aged 65 years and those who have previously been vaccinated with one or more doses of polysaccharide pneumococcal 23-valent vaccine (PPV23) 5 years before enrollment in study. In each study there were healthy adults and immunocompetent patients with chronic diseases in the compensation stage, including concomitant pathology that formed an increased susceptibility to pneumococcal infection (chronic cardiovascular diseases, chronic lung diseases including asthma, kidney and diabetes, chronic liver disease, including alcohol abuse), and adults with social risk factors - smoking and alcohol abuse. Immunogenicity and safety Prevenar 13 is demonstrated for adults aged 18 years and older, including patients previously vaccinated with PPV23. Immunological equivalence is established for 12 common seroprevalence-23 serotypes. In addition, for a total of 8 serotypes common to VPV23 and to serotype 6A, unique to Prevenar 13, a statistically significantly higher immune response to Prevenar 13 was demonstrated.In adults aged 18-59 years, the CGT of opsonophagocytic activity (OFA CGT) to all 13 serotypes of Prevenar 13 was not lower than that of adults aged 60-64 years. Moreover, persons aged 50-59 years gave a statistically higher immune response to 9 of 13 serotypes compared to people aged 60-64 years.

 

Prevenar 13 was demonstrated in a randomized, double-blind, placebo-controlled CAPITA study (more than 84,000 patients) for community-acquired pneumococcal pneumonia (PPP) in adults 65 years and older: 45% for the first runway episode caused by serotypes overlapping Prevenar 13 (invasive and non-invasive); 75% for invasive infections caused by serotypes overlapping Prevenar 13.

 

Immune response in adults previously vaccinated with PPV23

 

In adults 70 years and older, once vaccinated with PPV23 more than 5 years ago, the introduction of Prevenar 13 demonstrated immunological equivalence for 12 common serotypes compared with response to PPV23, with 10 immune responses to Prevenar 13 being statistically statistically negative for 10 common serotypes and serotype 6A is significantly higher in comparison with the response to PPV23. Prevenar 13 gives a more pronounced immune response compared to PPV23 revaccination.

 

Immune response in specific patient groups

 

Patients with the diseases described below are at increased risk of pneumococcal infection.

 

Sickle-cell anemia

 

In an open noncomparative study involving 158 children and adolescents aged> 6 and less than 18 years with sickle cell anemia previously vaccinated with one or more doses of PPV23 at least 6 months before enrollment, it was found that the administration of the first dose of Prevenar 13 with a double immunization with a 6-month interval resulted in a statistically significant high immune response (SGKIgG for each serotype, determined by the enzyme immunoassay (ELISA) method, and OFA CGR for each serotype). After the second dose, the immune response was comparable to that after the first dose of the drug.

 

HIV infection

 

HIV-infected children and adults with a CD4 count of more than 200 cells / μl (an average of 717.0 cells / μl), a viral load of less than 50,000 copies / ml (an average of 2,090.0 copies / ml), no active AIDS-associated diseases and no previous who received vaccinations with pneumococcal vaccine, received 3 doses of Prevenar 13. IgG scores and OFA values ​​were significantly higher after the first vaccination of Prevenar 13 compared to the pre-vaccination level.The second and third doses (at 6 and 12 months) developed a higher immune response than after a single vaccination with Prevenar 13.

 

Hematopoietic Stem Cell Transplantation

 

Children and adults who underwent allogeneic transplantation of hematopoietic stem cells (TSCC), aged more than 2 years with complete hematologic remission of the underlying disease or with satisfactory partial remission in the case of lymphoma and myeloma, received three doses of Prevenar 13 with an interval of at least 1 month between doses. The first dose of the drug was administered 3-6 months after TSCC. The fourth (booster) dose of Prevenar 13 was administered 6 months after the third dose. In accordance with general recommendations, a single dose of PPV23 was administered 1 month after the fourth dose of Prevenar 13. The titers of functionally active antibodies (OFASGT) were not determined in this study. Introduction Prevenar 13 caused an increase in SGS serotype-specific antibodies after each dose. The immune response to the booster dose of Prevenar 13 was significantly higher for all serotypes compared to the response to the primary immunization series.

 

Composition

 

Pneumococcal conjugates (polysaccharide + CRM197) serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F + auxiliary substances.

 

Indications

 

Prevention of pneumococcal infections, including invasive (including meningitis, bacteremia, sepsis, severe pneumonia) and non-invasive (community-acquired pneumonia and otitis media) forms of diseases caused by Streptococcus pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F , 9V, 14, 18C, 19A, 19F and 23F from 2 months of life and further without age restriction:

• in the national calendar of preventive vaccinations;
• in people at high risk of developing pneumococcal infection.

 

Vaccination is carried out within the framework of the national calendar of preventive vaccinations according to the approved deadlines, as well as to persons at risk for developing pneumococcal infection: immunodeficient conditions, incl. HIV infection, oncological diseases receiving immunosuppressive therapy; with anatomical / functional aspiration; with the established cochlear implant or planned for this operation; patients with leakage of cerebrospinal fluid; with chronic diseases of the lungs, cardiovascular system, liver, kidneys and diabetes mellitus; patients with bronchial asthma; premature infants; persons who are in organized collectives (orphanages, boarding schools,army collectives); convalescent acute otitis media, meningitis, pneumonia; long and often sick children; patients infected with mycobacterium tuberculosis; to all persons over 50; tobacco smokers.

 

Forms of release

 

Suspension for intramuscular injection (injections in ampoules or syringes for injection) (sometimes mistakenly called a solution).

 

Instructions for use and vaccination schedule

 

Method of administration

 

The vaccine is given in a single dose of 0.5 ml intramuscularly. Children of the first years of life are vaccinated in the upper-upper surface of the middle third of the thigh, persons older than 2 years - in the deltoid muscle of the shoulder.

 

Prior to use, the syringe with Prevenar 13 should be shaken well until a homogeneous suspension is obtained. Do not use if foreign particles are detected when inspecting the contents of the syringe.

 

Do not administer Prevenar 13 intravascularly and intramuscularly to the gluteal region!

 

If Prevenar 13 is vaccinated, it is recommended that it also be completed with Prevenar 13. With a forced increase in the interval between injections of any of the above vaccination courses, the introduction of additional Prevenar 13 doses is not required.

 

Vaccination schedule

 

Children 2-6 months:

Individual immunization: 3 doses with an interval of at least 4 weeks between administrations. The first dose can be administered from 2 months. Revaccination once in 11-15 months.

Mass immunization of children: 2 doses with an interval of not less than 8 weeks between administrations. Revaccination once in 11-15 months.

 

Children 7-11 months old:

2 doses with an interval of at least 4 weeks between administrations. Revaccination once in the second year of life.

 

Children 12-23 months old:

2 doses with an interval of not less than 8 weeks between administrations.

 

Children 2 years and older:

Once.

 

Children previously vaccinated by Prevenar

 

Vaccination against pneumococcal infection initiated by the 7-valent Prevenar vaccine may be continued with Prevenar 13 at any stage of the immunization schedule.

 

Persons aged 18 years and over

 

Preventor 13 is introduced once. The need for revaccination Prevenar 13 is not established. The decision on the interval between the introduction of vaccines Prevenar 13 and PPV23 should be taken in accordance with official guidelines.

 

Special patient groups

 

In patients after hematopoietic stem cell transplantation, a series of immunizations consisting of 4 doses of Prevenar 13 to 0.5 ml is recommended.The first series of immunizations consists of the administration of three doses of the drug: the first dose is administered from the third to the sixth month after transplantation. The interval between administrations should be 1 month. The revaccination dose is recommended to be administered 6 months after the administration of the third dose.

 

Preterm infants are recommended a four-time vaccination. The first series of immunizations consists of 3 doses. The first dose should be administered at the age of 2 months, regardless of the weight of the child with an interval of 1 month between doses. The introduction of the fourth (booster) dose is recommended at the age of 12-15 months.

 

Elderly patients

 

Immunogenicity and safety of the Prevenar vaccine 13 have been confirmed for elderly patients.

 

Side effect

 

Prevenar 13 safety was studied in healthy children (4,429 children / 14,267 vaccine doses) between the ages of 6 weeks and 11-16 months and 100 children born prematurely (less than 37 weeks gestation). Prevenar 13 was used concomitantly with other vaccines (including ADP, DTP) recommended for this age in all studies.

 

In addition, the safety of the Prevenar 13 vaccine was evaluated in 354 children aged 7 months to 5 years who had not previously been vaccinated with any of the pneumococcal conjugate vaccines.The most frequent adverse reactions were reactions at the injection site, fever, irritability, decreased appetite, and disturbed sleep. In older children, with the initial vaccination of Prevenar 13, a higher incidence of local reactions was observed than in children of the first year of life.

 

When Prevenar was vaccinated, 13 premature infants (born less than 37 weeks gestation), including deeply premature babies born less than 28 weeks of gestation and children with extremely low body weight (less than 500 g), the frequency and severity of post-vaccination reactions (after vaccination Prevenar 13) did not differ from those of full-term children.

 

Persons aged 18 years and older had fewer side effects, regardless of previous vaccinations. However, the frequency of the development of the reactions was the same as that of the vaccinated younger age.

 

In general, the incidence of adverse events was similar in patients aged 18-49 years and in patients older than 50 years, with the exception of vomiting. This side effect in patients aged 18 to 49 years was more common than in patients over the age of 50 years.

 

Adult patients with HIV had the same incidence of adverse reactions as in patients aged 50 years and older, with the exception of fever and vomiting, which were very frequent and nausea, which was observed frequently.

 

In patients after hematopoietic stem cell transplantation, the incidence of adverse reactions was similar to that in healthy adult patients, with the exception of fever and vomiting, which were very frequent in patients after transplantation. In children and adolescents with sickle cell disease, HIV infection or after hematopoietic stem cell transplantation, the same incidence of adverse reactions was observed as in healthy patients aged 2-17 years, with the exception of headache, vomiting, diarrhea, fever, fatigue, arthralgia and myalgia, which in such patients were encountered as very frequent.

 

Undesirable reactions identified in clinical trials Prevenar 13

• hyperthermia;
• irritability;
• redness of the skin, pain, tightness or swelling of 2.5-7.0 cm at the injection site (after revaccination and / or in children aged 2-5 years);
• nausea, vomiting (in patients aged 18 to 49 years);
• diarrhea;
• rash;
• drowsiness;
• deterioration of sleep;
• deterioration of appetite;
• headache;
• generalized new or exacerbation of existing joint pain and muscle pain;
• chills;
• fatigue;
• tearfulness;
• convulsions (including febrile seizures);
• hypersensitivity reactions at the injection site (hives, dermatitis, pruritus);
• cases of hypotonic collapse;
• flushes of blood to the face;
• dyspnea;
• bronchospasm;
• Quincke edema of different localization, including edema of the face;
• anaphylactic / anaphylactoid reaction;
• lymphadenopathy in the injection site.

 

Adverse events observed in other age groups can also occur in children and adolescents aged 5-17 years. However, in clinical trials, they were not noted because of the small number of participants.

 

Significant differences in the incidence of side effects in adults, previously vaccinated and unvaccinated PPV23, were not noted.

 

Contraindications

• increased sensitivity to the previous administration of Prevenar 13 or Prevenar (including anaphylactic shock, severe generalized allergic reactions);
• hypersensitivity to diphtheria toxoid and / or excipients;
• acute infectious or non-infectious diseases, exacerbations of chronic diseases. Vaccination is performed after recovery or during remission.

 

Application in pregnancy and lactation

 

The safety of the vaccine during pregnancy and breastfeeding has not been established. Data on the use of Prevenar 13 during pregnancy are absent. There are no data on the isolation of vaccine antigens or post-vaccination antibodies with breast milk during lactation.

 

Use in children

 

It is possible to use the vaccine in children, including infants according to the age-related dosages and vaccination schemes mentioned above.

 

special instructions

 

Given the rare cases of anaphylactic reactions that occur with any vaccine, the vaccinated patient should be under medical supervision for at least 30 minutes after immunization. Places of immunization should be provided with anti-shock therapy.

 

Vaccination of preterm (as well as full-term) children should start from the second month of life (passport age). When deciding on the vaccination of a premature baby (born before 37 weeks of gestation),especially those with a history of immaturity of the respiratory system, it must be taken into account that the benefit of immunization against pneumococcal infection in this group of patients is particularly high and neither vaccination should be abandoned nor delayed. Due to the potential risk of apnea in any vaccine, the first Prevenar vaccination for 13 premature babies is possible under medical supervision (at least 48 hours) in the hospital at the second stage of nursing.

 

Like other intramuscular injections, patients with thrombocytopenia and / or other disorders of the blood coagulation system and / or anticoagulant treatment, Prevenar 13 should be given with caution, provided that the patient's condition is stabilized and hemostasis is achieved. Subcutaneous administration of Prevenar vaccine 13 to this group of patients is possible.

 

Prevenar 13 can not provide prevention of diseases caused by pneumococci of other serotypes, the antigens of which are not included in this vaccine.

 

Children from high-risk groups under 2 years of age should be vaccinated against Prevenar 13 according to their age.In patients with impaired immunoreactivity, vaccination may be accompanied by a decreased level of antibody formation.

 

Application Prevenar 13 and PPV23

 

For the formation of immune memory, immunization against pneumococcal infection is preferably initiated with the Prevenar vaccine 13. The need for revaccination is not defined. Individuals from high-risk groups to expand coverage of serotypes may subsequently be recommended to introduce PPV23. There are data from clinical trials of vaccination of PPV23 at 1 year and also 3.5-4 years after Prevenar 13. At an interval between vaccinations of 3.5-4 years, the immune response to PPV23 was higher without changes in reactogenicity.

 

Children vaccinated with Prevenar 13 and belonging to a high-risk group (eg, sickle-cell anemia, asplenia, HIV infection, chronic disease or immune dysfunction), PPV23 should be injected at least 8 weeks apart. In turn, patients who are at high risk of pneumococcal disease (patients with sickle cell anemia or HIV infection), including patients previously vaccinated with one or more doses of PPV23, may receive at least one dose of Prevenar vaccine 13.

 

The decision on the interval between the introduction of PPV23 and the vaccine Prevenar 13 should be taken in accordance with official recommendations. In a number of countries (USA), the recommended interval is at least 8 weeks (up to 12 months). If the patient has previously been vaccinated with PPV23, Prevenar 13 should not be administered more than 1 year later. In Russia, vaccination of PKV13 is recommended for all adults who have reached the age of 50 years and for patients at risk, the PKV13 vaccine being administered first with possible subsequent revaccination of PPV23 at intervals of not less than 8 weeks.

 

Prevenar 13 contains less than 1 mmol sodium (23 mg) per dose, ie, practically free of sodium.

 

Within the indicated shelf life, Prevenar 13 remains stable for 4 days at a temperature of up to 25 ° C. At the end of this period, the drug should either be used immediately, or returned to the refrigerator. These data are not guidance on the storage and transport conditions, but may be the basis for a decision on the use of the vaccine in the case of temporary fluctuations in temperature during storage and transport.

 

Impact on the ability to drive a vehicle or potentially dangerous machinery

 

Prevenar 13 has little or no effect on the ability to drive and use machinery. However, some adverse reactions may temporarily affect the ability to drive a vehicle and potentially dangerous mechanisms.

 

Drug Interactions

 

Data on the interchangeability of Prevenar 13 on other pneumococcal conjugate vaccines are not available. With simultaneous immunization of Prevenar 13 and other vaccines, injections are made in different parts of the body.

 

Children aged 2 months - 5 years

 

Preventor 13 is combined with any other vaccines included in the immunization schedule for infants of the first years of life, with the exception of BCG. The simultaneous administration of Prevenar 13 with any of the following antigens that are part of both monovalent and combination vaccines: diphtheria, tetanus, acellular or whole-cell pertussis, Haemophilus influenzae type b, polio, hepatitis A, hepatitis B, measles, mumps, rubella, varicella and rotavirus infection - does not affect the immunogenicity of these vaccines. In connection with a higher risk of developing febrile reactions to children with convulsive disorders, incl.with febrile seizures in the anamnesis, and also receiving Prevenar 13 concomitantly with whole-cell pertussis vaccines, symptomatic antipyretic agents are recommended. With the combined use of Prevenar 13 and Infanrix Hex, the frequency of febrile reactions coincided with that for the joint use of Prevenar (PKV7) and Infanrix Hex. Increased frequency of reporting seizures (with and without body temperature increase) and hypotonic-hypo-sensitive episodes (GGE) was observed with the joint use of Prevenar 13 and Infanrix Hex. The use of antipyretic drugs should be started according to local recommendations for the treatment of children with convulsive disorders or children with a history of febrile seizures, and in all children who received Prevenar 13 concomitantly with vaccines containing the whole-cell pertussis component.

 

According to a post-marketing study of the prophylactic use of antipyretics for the immune response to the introduction of the Prevenar vaccine 13, it is suggested that the prophylactic administration of acetaminophen (paracetamol) may reduce the immune response to the Prevenar vaccination series 13.The immune response to the revaccination of Prevenar 13 at 12 months with the preventive use of Paracetamol does not change. The clinical significance of this data is not known.

 

Children and adolescents aged 6 to 17 years

 

Data on the use of Prevenar 13 at the same time as the vaccine against human papillomavirus infection, conjugated meningococcal vaccine, tetanus, diphtheria and pertussis vaccine, tick-borne encephalitis are not available.

 

Persons aged 18-49 years

 

Data on the simultaneous use of Prevenar 13 with other vaccines are not available.

 

Persons aged 50 years and over

 

The vaccine Prevenar 13 can be used in conjunction with a trivalent inactivated seasonal influenza vaccine (DVT). With the combined use of Prevenar 13 and DVT vaccines, immune responses to the DVT vaccine coincided with those obtained with a single DVT vaccine, the immune responses to Prevenar 13 were lower than with Prevenar 13. The clinical significance of this fact is unknown. The incidence of local reactions did not increase with simultaneous administration of Prevenar 13 with an inactivated influenza vaccine, whereas the frequency of general reactions (headache, chills, rash,loss of appetite, pain in the joints and muscles) with simultaneous immunization was increased. Simultaneous use with other vaccines has not been investigated.

 

Analogues of Prevenar 13

 

Structural analogs for the active substance:

• Pneumo 23;
• Prevenar (pneumococcal polysaccharide conjugated adsorbed vaccine);
• Sinflorix (Vaccine 10-valent pneumococcal polysaccharide, conjugated with D-protein, non-typed Haemophilus influenza, tetanus and diphtheria toxoid, adsorbed);
• Pneumovax 23 (Vaccine pneumococcal, polyvalent).

Similar medicines:

Other medicines: