New Vaccine Product Available Through VFC: Penbraya (MenABCWY)

On October 20, 2023, the FDA licensed Pfizer’s pentavalent vaccine Penbraya to prevent meningococcal serogroups A, B, C, W, and Y.

As a reminder, MenB vaccines are not interchangeable. The same vaccine (either Bexsero by GSK or Trumenba by Pfizer) must be used for all doses in the MenB series, including booster doses. The pentavalent MenABCWY product Penbraya (Pfizer) contains MenB-Fhbp (Trumenba) as its MenB component; therefore, Penbraya should only be used in series with Trumenba.

To add this formulation to the list of vaccines that your site orders, use the button below to complete the change request form.

Our team will review your request and reply with next steps. We recommend that sites that are affiliated or part of a system use the same vaccine presentations across sites to ensure continuity of care and help prevent administration errors.

To purchase this vaccine in the private market, please contact your local Pfizer sales rep at brian.bengston@pfizer.com. 

Penbraya 1 Dose Kit and Penbraya 5 Dose Kit are now available through the Vaccines for Children (VFC) program. 

• The Advisory Committee on Immunization Practices (ACIP) recommends MenABCWY for ages 10 through 25. Penbraya may be used when both MenACWY and MenB are indicated at the same visit. More specifically, MenABCWY is recommended for the following groups based on shared clinical decision-making:
• Healthy individuals aged 16 to 23 years due for their MenACWY booster and MenB vaccination at the same visit. 
• Children 10 years and older with complement deficiency, functional or anatomic asplenia (including sickle cell disease), or receiving complement inhibitors. 
• CVX code: 316 
• CPT code: 90623 
• NDC number: 00069-0600-01 (1 Dose Kit) and 00069-0600-05 (5 Dose Kit) 

Resources

• How to prepare Penbraya
• Prescribing information
• Blog post: New meningococcal vaccine for pediatric patients
• FDA resource: Penbraya
• Immunize.org: Ask the experts
• MenACWY VIS: Vaccine information
• MenB VIS: Vaccine information
• MenB Recommendation Guide
• MenABCWY MMWR: Use of the Pfizer pentavalent meningococcal vaccine among persons aged ≥ 10 Years.

If you have any questions, please email vaccines@phila.gov.

Catch Up Pediatric Patients: MMR Vaccine

There is a measles cluster in Philadelphia that started with an infant and spread to unvaccinated individuals. It has resulted in now 7 confirmed cases of measles among Philadelphia residents and an index case in Delaware county.

To prevent further spread, review your pediatric patients’ records for MMR vaccine and recall any patients who are not up to date. Consider nurse-only visits to get patients in faster. 

Measles is highly infectious and can be especially dangerous to children under 5, pregnant people, and immunocompromised individuals. CDC recommends children get their first MMR dose at 12-15 months and the second dose at 4-6 years. 

You can order a free measles flyer below.

Vaccine Product Available Through VFC: Abrysvo

Abrysvo is a maternal RSV vaccine available through the Vaccines for Children (VFC) program. 

RSV is surging and the pediatric infant immunization Beyfortus supply is severely limited. Abrysvo will play an important role in protecting infants against severe RSV disease this season. Most infants born to mothers who have received Abrysvo will not need to receive Beyfortus. 

Please note that the availability of Abrysvo for VFC providers is limited. Only sites that care for pregnant people under 19 can order, and orders will be limited to 5 doses per site at a time.

Abrysvo

Abrysvo is a Pfizer product now available through the Vaccines Children (VFC) program.

• CVX code: 305
• CPT code: 90678
• NDC number: 00069-0344-01

V-safe, one of several systems CDC uses to closely monitor the safety of vaccines, will be used as a health check for pregnant people who receive a maternal RSV vaccine.

For more information, review the package insert.

Additional resources:

FDA page
VIS

If you have any questions, please email vaccines@phila.gov.

Administration Errors: RSV for Infants

On November 30, CDC alerted immunization programs that they have received reports of infants being mistakenly administered RSV vaccines intended for adults. Infants should only receive the RSV preventive antibody, nirsevimab (Beyfortus, Sanofi).

RSV vaccines (Arexvy by GSK and Abrysvo by Pfizer) are recommended only for adults and have not been evaluated for safety or effectiveness in infants or children. Practices that carry both adult RSV vaccine and pediatric RSV preventive antibody products should review their immunization administration safety procedures to ensure only the correct product is administered to recipients. This is an opportunity to re-educate and re-train staff on RSV immunization formulations and practices.

In the event that a vaccine administration involving RSV vaccine occurs, CDC encourages vaccinators to promptly report errors to the Vaccine Adverse Event Reporting System (VAERS). Also, inform parents of error so that these infants can receive the correct product and be monitored for adverse reactions. 

CDC Clinical Guidance (updated December 7, 2023)

Because there are no data on the efficacy/effectiveness of RSV vaccines in preventing RSV disease in this age group, the infant should receive nirsevimab if otherwise eligible based on maternal RSV vaccination status. There is no specific recommendation for a minimum interval between administration of incorrect RSV vaccine and nirsevimab. Some experts suggest:

• That it could be reasonable to consider waiting 48 to 72 hours before proceeding with nirsevimab administration. This time frame is when we would expect side effects to the RSV vaccine, such as fussiness, would be most likely.

• Consideration should be given to administering nirsevimab in the limb opposite to where the RSV vaccine was administered to avoid potential interaction or binding of RSV antibody and vaccine, thereby reducing the effectiveness of nirsevimab.

If further clinical guidance is needed, connect with our medical experts at vaccines@phila.gov or CDC experts at NIPINFO@cdc.gov.