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Pneumococcal Vaccine (Prevnar 13 and Pneumovax 23) ACIP Guidelines’ Impact on KOLs and PCP; UNKNOWN VS KNOWNS-a study by Mellalta Meets 2020

Mellalta Meets conducted a survey in the United States to understand doctors’ and KOL’s concerns and opinion regarding the impact of recent ACIP guidelines on Pneumococcal Vaccine prescriptions (Prevnar 13 and Pneumovax 23)

What is answered!

  • Changing Pneumococcal Vaccine prescription trends
  • Level of adoption of shared clinical decision making 
  • Concerns of KOLs 
  • Concerns of PCPs (A primary care physician)
  • How important is health literacy?
  • Prescription of both Prevnar 13 and Pneumovax 23 
Prevnar 13 (PCV13)  Pfizer and Pneumovax 23  (PPSV23)  Merck
Prevnar 13 (PCV13)  Pfizer and Pneumovax 23  (PPSV23)  Merck
Prevnar 13 (PCV13)  Pfizer and Pneumovax 23  (PPSV23)  Merck
Prevnar 13 (PCV13)  Pfizer and Pneumovax 23  (PPSV23)  Merck
Prevnar 13 (PCV13)  Pfizer and Pneumovax 23  (PPSV23)  Merck
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Lets Dive in!

ACIP recommends Merck’s Pneumovax23 (PPSV23) in latest recommendations for adults 65 and older

Pfizer-Prevnar 13 (PCV13)

  • Prevnar 13 (PCV13) is now recommended based on Shared Clinical Decision Making.
  • Shared Decision Making for ≥65 aged adults who do not have an immunocompromising condition, cerebrospinal fluid leak, or cochlear implant and who have not previously received PCV13 (Prevnar 13).
  • ACIP recognized that some adults aged ≥65 years are potentially at increased risk for exposure to Prevnar 13 serotypes, such as persons residing in nursing homes or other long-term care facilities and persons residing in settings with low pediatric Prevnar 13 uptake or traveling to settings with no pediatric Prevnar 13 program, and might attain higher than average benefit from Prevnar 13 vaccination.

 Merck -PPSV23

  • The recommendation for Pneumovax 23 (PPSV23) has not changed
  • Continues to hold a Routine recommendation for healthy adults 65 and older

Impact of change in guidelines

  • All adults aged ≥65 years should continue to receive 1 dose of PPSV23 (Pneumovax 23)
  • If the decision is made to administer Prevnar 13 (PCV13), it should be given at least 1 year before PPSV23 (Pneumovax 23)
  • ACIP continues to recommend PCV13 in series with PPSV23 for adults aged ≥19 years with an immunocompromising condition, CSF leak, or cochlear implant.

Study Methodology 

Mellalta Meets conducyed a Survey of total primary care physicians and KOLs N= 10. Study was conducted in May 2020 and was done in the United States

Key Takeaways 

  • 90% of the PCPs will recommend both Prevnar 13 and Pneumovax 23 to avoid any risk in adults aged 65 and older
  • PCPs are not willing to take even 1% risk with patients’ health by prescribing just Pneumovax23

Deep Dive

Trends

PCPs Perspective

Agree (%)

Concerns of PCPs

Shared Clinical Decision Making

Shared Clinical Decision allows PCPs to discuss with patients related to their health followed by recommendations of Prevnar 13 and Pneumovax 23 [both] or Pneumovax 23 alone

100%

No clear guidelines of prescribing Pneumococcal Vaccine through Shared Clinical decision making

•       Confusing to PCPs and other healthcare professionals

•       Herd immunity from serotypes in one geographical location will not be same as compared to another geographical location.

•       Health literacy rate in country is concern as it could be a possibility that senior’s citizen will not ask any questions to the provider.

•       Every physician is not well informed about the guidelines.

•       Fear of biased decision by physician in written prescription

Prescription of both Prevnar 13 and Pneumovax 23

•       PCPs will prescribe both Prevnar 13 and Pneumovax 23 to adults 65 years of age and older-

•       Persons at high risk includes smoking, diabetic or suffering from heart diseases or lung defects.

•       Persons residing in nursing homes or other long-term care facilities

•       Persons residing in settings with low pediatric PCV13 uptake

•       Persons traveling to settings with no pediatric PCV13 program

•       Decision will be made based on clinical understanding

90%

•       PCPs will discuss with patients on the basis of shared clinical decision making but will advise them to take both Prevnar 13 and pneumovax 23 to avoid any risk

 

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