Update on Pneumococcal Vaccination in Pediatrics: Recent Evidence and Recommendations from the Panamanian Pediatric Society

Abstract

Introduction: Pneumococcal disease is a major cause of morbidity and mortality in childhood. Panama has included the pneumococcal vaccine in its national immunization schedule since 2008, with an update in 2011. Conjugate vaccines have significantly reduced its impact however, the emergence of new serotypes and differences in immunogenicity among available options require updated vaccination strategies. Materials and Methods: A review of scientific literature from the past five years was conducted, including phase 3 clinical trials, epidemiological surveillance data, and cost-effectiveness analyses of PCV13, PCV15, and PCV20 pneumococcal vaccines. Results: PCV15 and PCV20 demonstrated safety and immunogenicity profiles comparable to PCV13. PCV15 showed a better immune response to serotype 3 and provided additional protection against serotypes 22F and 33F. PCV20 offers broader coverage  however, it shows a lower immune response to some serotypes. A predicted effectiveness study indicated that PCV15 maintains protection comparable to PCV13 and PCV7 for most shared serotypes, with a significant immunological advantage against serotype 3, while PCV20 provides broader coverage but demonstrates lower overall immunogenicity compared to lower-valency vaccines. Cost-effectiveness analyses conducted in various countries support the incorporation of PCV20 into vaccination schedules. Conclusions: PCV15 and PCV20 are safe and effective alternatives for preventing pneumococcal disease in children. The Panamanian Pediatric Society recommends systematic vaccination with PCV15 or PCV20 in 2+1 or 3+1 schedules, ensuring the administration of a booster dose for optimal protection. Epidemiological surveillance and adherence to the vaccination schedule are essential to optimize impact. In this context, the country’s choice of vaccine should ideally be based on the current circulation of serotypes not covered by PCV13 in the pediatric population.