Pneumonia Vaccine Campaign by Pfizer – Serious Questions? – Asrar Qureshi’s Blog Post #880

Pneumonia Vaccine Campaign by Pfizer – Serious Questions? – Asrar Qureshi’s Blog Post #880

Dear Colleagues!  This is Asrar Qureshi’s Blog Post #880 for Pharma Veterans. Pharma Veterans  aims to share knowledge and wisdom from Veterans for the benefit of Community at large. Pharma Veterans Blog is published by Asrar Qureshi on  WordPress, the top blog site. Please email to asrar@asrarqureshi.com for publishing your contributions here.

Credit: Alina Kurson

Pfizer has recently launched (unleashed?) an aggressive campaign for its pneumonia vaccine PREVENAR13 (internationally PREVNAR13) for use in adults over 65 years of age. They have made emotionally charged advertisements in which their vaccine is being projected as the best gift for parents and grandparents. The emotion-soaked adverts make the audience feel guilty if they will not get their parents/grandparents vaccinated with Pfizer vaccine. You can use these links to see the ads on YouTube.

https://www.youtube.com/watch?v=191ND1vJuus

https://www.youtube.com/watch?v=-7azeBoE7EY

https://www.youtube.com/watch?v=pADmhr4l8vI

https://www.youtube.com/watch?v=Y8X8ynedFik

Ethics of Big Pharma world over had been under serious questions and Pfizer and other big companies have paid heavy fines for unethical practices. However, it has never deterred Big Pharma who continue with their profiteering campaigns. Pfizer has new courage since it was the greatest beneficiary of COVID19 as it sold the highest amount of their vaccine, which was most expensive also. Pfizer raked in billions of dollars and touched new heights of profitability.

I would like to raise two very basic questions here about the recent campaign of pneumococcal vaccine.

Question #1

Why is Pfizer promoting Prevenar13 in Pakistan for adults 65 years and older when it has been replaced by Prevnar20 in North America? Is it an effort to sell the discarded, unsold stocks in third world countries? 

Pfizer still sells Prevenar13 in Pakistan whereas Prevnar20 was approved by USFDA in 2020, which covers 7 more strains and is now recommended by CDC – Center for Disease Control USA for use in adults 65 years and older. Prevnar 13 is now outdated, and Pfizer shall not be able to sell it in this age bracket in the developed countries. 

Let me share the latest information on this subject.

Here is the CDC USA recommendation:

Vaccination of Adults 65 Years or Older 

Routine Recommendation

CDC recommends routine administration of pneumococcal conjugate vaccine (PCV15 or PCV20) for all adults 65 years or older who have never received any pneumococcal conjugate vaccine or whose previous vaccination history is unknown:

• If PCV15 is used, this should be followed by a dose of PPSV23 one year later. The minimum interval is 8 weeks and can be considered in adults with an immunocompromising condition†, cochlear implant, or cerebrospinal fluid leak.

• If PCV20 is used, a dose of PPSV23 is NOT indicated.

{PCV15 is a Merck vaccines that covers 15 strains; PCV20 is Prevnar20; PPSV23 is also Merck Vaccine covering 23 strains but made with a different technology}

Recommendation for Shared Clinical Decision-Making

Based on shared clinical decision-making, adults 65 years or older have the option to get PCV20 if they have received

• PCV13 (but not PCV15 or PCV20) at any age

AND

• PPSV23 at or after the age of 65 years old

An article by Drug Information Group, University of Illinois, Chicago concludes:

[Quote] Because PCV13-type disease is at historically low levels among adults ≥65 years and most pneumococcal disease among these adults is due to non-PCV13 serotypes, ACIP no longer recommends their routine vaccination with PCV13. Shared clinical decision-making is now recommended for adults ≥65 years who do not have an immunocompromising condition, CSF leak, or cochlear implant and who have not previously received PCV13. Adults ≥65 years should continue to receive PPSV23 vaccine at the previously recommended schedule. [Unquote]

Abigail Zuger writes in Jwatch.org article of Feb 2022:

[Quote] Two new conjugate vaccines replace Prevnar-13.

Recommendations for vaccinating adults against pneumococcal disease have changed three times in the past decade, and now they are changing yet again, with the recent U.S. FDA approval of two new pneumococcal conjugate vaccines (PCVs).

The 15-valent PCV (PVC15; Vaxneuvance, Merck) and the 20-valent PCV (PVC20; Prevnar-20, Wyeth/Pfizer) add additional serotypes to those contained in the older 13-valent PCV (PVC13; Prevnar-13, Wyeth). All three PCVs are more immunogenic than the venerable 23-valent polysaccharide-based Pneumovax (PPSV23), although the latter covers more serotypes. Both new PCVs elicited good immunologic responses in adult volunteers; actual clinical data are not available for either one. They are not yet approved for children.

The updated recommendations apply to all older adults (age, ≥65) and to all adults who are at elevated risk for pneumococcal disease because of immunocompromise or comorbidity.

• Eligible adults who have received no pneumococcal vaccinations or have unknown vaccination histories should receive either a single dose of PCV20 with nothing further or PCV15 followed 1 year or later by a “chaser” of PPSV23. This interval can be shortened to 8 weeks for individuals at particularly high risk.

• Eligible adults who have received only PPSV23 may receive one of the new PCVs at 1 year or later after their PPSV23 vaccination; no additional PPSV23 doses are advised.

• Eligible adults who have received PCV13 alone should receive a chaser dose of PPSV23 at 1 year or later, as advised in the previous set of guidelines. No data addresses the utility of additional doses of the newer PCVs in these patients, and no further vaccinations are recommended for them at present. [Unquote]

Question #2

Why is Pfizer fueling social disparity which already exists due to unequal distribution of resources? 

Prevenar13 costs Rs. 6855 for one injection in Pakistan. If both parents are alive, it would cost 13000 rupees to vaccinate them. In these times of excessive inflation, when families are struggling to survive, this advert exerts highly unwanted pressure on them. It is straight emotional blackmailing. If a family cannot afford, their parents will feel deprived, and the children will feel guilty. If a parents falls sick due to any respiratory problem and God Forbid, passes away, the children will blame themselves for the rest of their lives. The advertisement plays cruelly on the sentiments of unsuspecting people. I may add that respiratory problems have increased manifold due to pollution and other factors. These problems cannot be addressed with Prevenar vaccination, but Pfizer advert does not make it clear that vaccination may protect only against a limited problem. 

I strongly urge DRAP and other health authorities to take immediate notice, stop this campaign now, and issue show cause to Pfizer for misinformation.

Concluded.

Reference:

https://www.cdc.gov/vaccines/vpd/pneumo/hcp/recommendations.html#:~:text=Routine%20Recommendation-,CDC%20recommends%20routine%20administration%20of%20pneumococcal%20conjugate%20vaccine%20(PCV15%20or,of%20PPSV23%20one%20year%20later. 

https://dig.pharmacy.uic.edu/faqs/2020-2/march-2020-faqs/what-is-the-new-recommendation-for-13-valent-pneumococcal-vaccine-in-elderly-adults/#:~:text=Because%20PCV13%2Dtype%20disease%20is,their%20routine%20vaccination%20with%20PCV13.

https://www.jwatch.org/na54651/2022/02/22/new-recommendations-pneumococcal-vaccination-adults