MEDICAL ADVISORY: Pneumococcal Vaccine Program Transition, Recommendations for Children Previously Immunized with Oral Polio Vaccine, and Other Reminders

Issued by: Dr. Jessica Jackman, MD MPH FRCPC FACPM DipABLM, Associate Medical Officer of Health

Date: July 31, 2024

This medical advisory contains two updates: changes to the pneumococcal vaccine program, and updated recommendations for children previously immunized with oral polio vaccine (OPV).

Pneumococcal Vaccine Program transition

Ontario’s pneumococcal publicly funded vaccine program is transitioning to the following pneumococcal vaccines:

Pneumococcal 15-valent conjugate (Pneu-C-15), trade name Vaxneuvance^®
Pneumococcal 20-valent conjugate (Pneu-C-20), trade name Prevnar 20^®

Eligibility for these programs is not changing and re-vaccination is not part of the product transition. Any future changes in eligibility will be communicated separately. Individuals who have previously received all eligible publicly funded doses of pneumococcal vaccines based on their age and health history are not eligible to receive additional doses of publicly funded pneumococcal vaccines.

There are three pneumococcal vaccine programs in Ontario:

1. Routine vaccination program for children aged 6 weeks to 4 years (children who are at high risk for invasive pneumococcal disease (IPD) need to follow the high risk vaccination program, below)

Vaxneuvance^® will replace Prevnar^® 13
See Ministry fact sheet for children aged 6 weeks to 4 years

2. Routine vaccination program for individuals 65 years and older

Prevnar 20^® will replace Pneumovax^® 23
See Ministry fact sheet for individuals 65 years and older

3. High risk vaccination program for individuals aged 6 weeks and older with certain medical or non-medical conditions who are at high risk for IPD

Prevnar 20^® will replace both Prevnar^® 13 and Pneumovax^® 23 for high risk individuals
See the following fact sheets, by age, for more information:

Health care provider action

Use the General Vaccine Order Form or the High Risk Vaccine Order Form to order pneumococcal vaccines for your practice
Return any unused Prevnar^® 13 and Pneumovax^® 23 once you have received doses of Vaxneuvance^® and Prevnar 20^®

More information

Refer to the Ministry of Health’s Questions and Answers for Health Care Providers: Pneumococcal Vaccine Transition.

Ontario’s updated recommendations for children previously immunized with OPV

As per the memorandum sent to primary care providers from The Ministry of Health, please note the following recommendations and information related to children previously immunized with Oral Poliovirus Vaccine (OPV):

Individuals vaccinated on or after April 1, 2016 with OPV are presumed to have received bivalent OPV. Bivalent OPV contains poliovirus serotypes 1 and 3, but not serotype 2. These doses are now considered invalid and do not count towards completion of a polio vaccine series.
If OPV and a monovalent inactivated polio vaccine (IPV) were administered on the same day, on or after April 1, 2016, they are both considered invalid doses
If OPV and a combination product that contains IPV were administered on the same day, on or after April 1, 2016, the IPV dose is considered valid
For protection against all three poliovirus types, ensure that patients who received OPV on or after April 1, 2016 have received a sufficient number of trivalent polio vaccine doses (as per their age appropriate schedule)

For more information please see:

Ministry of Health’s Questions and Answers for Immunizers for scenarios and catch-up immunization schedules
Public Health Ontario’s Summary of Immunization Recommendations for Children Previously Immunized with Oral Poliovirus Vaccine
General Vaccine Order Form to place an order for vaccine
Polio | The Immunization Well-Child Toolkit | ontario.ca for general information on polio vaccination

Niagara Region Vaccine Hesitancy Survey

Please complete this 5 minute Vaccine Hesitancy survey to help us determine if a pocket resource would be useful to healthcare professionals

If you have further questions:

Call the Vaccine Preventable Disease program at 905-688-8248 or 1-888-505-6074 ext. 7396
Visit Immunization, Vaccine for Health Professionals