Abstract
  • On November 15, 2024, the Public Health Agency of Canada (PHAC) released the National Advisory Committee on Immunization's (NACI) Recommendations on the use of pneumococcal vaccines in adults, including Pneu-C-21. This guidance is based on current evidence and NACI expert opinion.
  • Many Canadians that have been eligible for existing pneumococcal immunization programs remain unvaccinated. Pneumococcal vaccination coverage among adults aged 18 and older continues to fall short of the national target goal of 80% by 2025, representing missed opportunities for infection prevention.
  • Invasive pneumococcal disease (IPD) carries a substantial risk of serious health complications and significant mortality, emphasizing the importance of immunization as one of the most effective preventive strategies.
  • Health Canada authorized a new product to protect adults 18 years of age and older against IPD on July 15, 2024:
    • Pneu-C-21 (CAPVAXIVE®, Merck) was authorized for adults 18 years of age and older, with an indication for prevention of IPD caused by 21 serotypes of S. pneumoniae (3, 6A, 7F, 8, 9N, 10A, 11A, 12F, 15A, 15C, 16F, 17F, 19A, 20A, 22F, 23A, 23B, 24F, 31, 33F, and 35B), and cross-protection against 2 additional serotypes (6C and 15B).

Following a review of the evidence of pneumococcal vaccines, including Pneu-C-21, NACI makes the following strong recommendations for public health program level decision-making:

  • Adult pneumococcal immunization programs in Canada should include at least one of Pneu-C-20 or Pneu-C-21.
  • One dose of either Pneu-C-20 or Pneu-C-21, regardless of pneumococcal vaccination history with Pneu-C-13, Pneu-C-15 or Pneu-P-23, should be given to:
    • Adults 65 years of age and older
    • Adults under 65 years of age at increased risk of IPD
    • Medical risk factors and certain social, behavioural and environmental conditions can increase the risk of severe IPD illness in adults. A full list of risk conditions can be found within the NACI statement, along with specific recommendations for hematopoietic stem cell transplant recipients.
  • NACI will continue to review emerging evidence and update guidance as needed.
Recommendation Americas Canada Adults Pneumococcal disease