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Device/Product name
Vaxneuvance
Active Ingredient
Pneumococcal 15-valent conjugate vaccine (CRM197 Protein)
Date of decision
Published
ATC codes
J07AL02
Decision
Approved
What was the decision based on
The decision was based on quality (chemistry and manufacturing),nonclinical (pharmacology and toxicology), clinical (pharmacology, safety and efficacy) and risk management plan information submitted by the sponsor. The benefit-risk profile of Vaxneuvance was considered favourable for the therapeutic use approved.
What steps were involved in the decision process

Vaxneuvance contains serotype specific pneumococcal capsular polysaccharides each of which is conjugated to a carrier protein (CRM197), and elicits antibodies that enhance opsonisation, phagocytosis, and killing of pneumococci to protect against pneumococcal disease. Vaxneuvance is also expected to elicit a T cell dependent immune response. Carrier protein specific helper T cells support specificity, functionality and maturation of serotype specific B cells.

Immune responses following natural exposure to S. pneumoniae or following pneumococcal vaccination can be determined through the measurements of opsonophagocytic activity (OPA) and immunoglobulin G (IgG) responses. OPA represents functional antibodies capable of opsonising pneumococcal capsular polysaccharides for presentation to phagocytic cells for engulfment and subsequent killing and are considered an important immunologic surrogate measure of protection against pneumococcal disease in adults. OPA titres are expressed as the reciprocal of the highest serum dilution that reduces survival of the pneumococci by at least 50%. A validated multiplexed opsonophagocytic assay (MOPA) was used to measure serotype specific OPA titres for each of the 15 serotypes contained in Vaxneuvance.

Registration timeline

The following table summarises the key steps and dates for this application.

Description Date
Submission dossier accepted and first round evaluation commenced 1 February 2021
First round evaluation completed 5 July 2021
Sponsor provides responses on questions raised in first round evaluation 30 August 2021
Second round evaluation completed 7 October 2021
Delegate's overall benefit-risk assessment and request for Advisory Committee advice 27 October 2021
Sponsor's pre-Advisory Committee response 16 November 2021
Advisory Committee meeting 1 December 2021
Registration decision (Outcome) 12 January 2022
Completion of administrative activities and registration on ARTG 17 January 2022
Number of working days from submission dossier acceptance to registration decision* 194

*Statutory timeframe for standard applications is 255 working days

Date of entry onto ARTG
Original publication date
Black triangle scheme
Yes. This product will remain in the scheme for 5 years, starting on the date the product is first supplied in Australia
Dose forms
Suspension for intramuscular injection
Strength
Each 0.5 mL dose contains 32 micrograms of total pneumococcal purified capsular polysaccharide (2 micrograms each of serotypes 1, 3, 4, 5, 6A, 7F, 9V, 14, 18C, 19A, 19F, 22F, 23F, and 33F, and 4 micrograms of serotype 6B) conjugated to 30 micrograms of non-toxic diphtheria CRM197 protein, adsorbed on 125 micrograms of aluminium (as aluminium phosphate adjuvant)
Other ingredients
Histidine, polysorbate 20, sodium chloride, water for injections
Containers
Prefilled syringe
Pack sizes
1 and 10
Routes of administration
IntramuscularThe preferred site for injection is the deltoid muscle of the upper arm in adults. The vaccine should not be injected in the gluteal area or areas where there may be a major nerve trunk and/or blood vessel.
Dosage

Single dose of 0.5 mL of Vaxneuvance

For further information refer to the Product Information.

Pregnancy category
B1Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed.Studies in animals have not shown evidence of an increased occurrence of fetal damage.The use of any medicine during pregnancy requires careful consideration of both risks and benefits by the treating health professional. This must not be used as the sole basis of decision making in the use of medicines during pregnancy. The TGA does not provide advice on the use of medicines in pregnancy for specific cases. More information is available from obstetric drug information services in your State or Territory.
What was approved

Vaxneuvance (pneumococcal 15-valent conjugate vaccine (CRM197 protein)) was approved for the following therapeutic use:

Vaxneuvance is indicated for active immunisation for the prevention of pneumococcal disease caused by Streptococcus pneumoniae serotypes (1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 22F, 23F and 33F) in adults 18 years of age and older.
Vaxneuvance may not prevent disease caused by S. pneumoniae serotypes that are not contained in the vaccine .
The use of Vaxneuvance should be guided by official recommendations.
What is this medicine and how does it work
Vaxneuvance contains serotype specific pneumococcal capsular polysaccharides each of which is conjugated to a carrier protein (CRM197), and elicits antibodies that enhance opsonisation, phagocytosis, and killing of pneumococci to protect against pneumococcal disease. Vaxneuvance is also expected to elicit a T cell dependent immune response. Carrier protein specific helper T cells support specificity, functionality and maturation of serotype specific B cells.Immune responses following natural exposure to S. pneumoniae or following pneumococcal vaccination can be determined through the measurements of opsonophagocytic activity (OPA) and immunoglobulin G (IgG) responses. OPA represents functional antibodies capable of opsonising pneumococcal capsular polysaccharides for presentation to phagocytic cells for engulfment and subsequent killing and are considered an important immunologic surrogate measure of protection against pneumococcal disease in adults. OPA titres are expressed as the reciprocal of the highest serum dilution that reduces survival of the pneumococci by at least 50%. A validated multiplexed opsonophagocytic assay (MOPA) was used to measure serotype specific OPA titres for each of the 15 serotypes contained in Vaxneuvance.
What post-market commitments will the sponsor undertake

Batch Release Testing and Compliance

  • It is a condition of registration that all independent batches of Vaxneuvance vaccine imported into Australia are not released for sale until samples and the manufacturer's release data have been assessed and sponsor have received notification acknowledging release from the Laboratories Branch, TGA.
    For each independent batch of the product imported into Australia, the sponsor must supply the following:
    • A completed Request for Release Form, available from vaccines@health.gov.au.
    • Complete summary protocols for manufacture and QC[quality control], including all steps in production in the agreed format.
    • At least 20 (twenty) vials (samples) of each manufacturing batch of Vaxneuvance vaccine with the Australian approved labels, PI [Product Information] and packaging (unless an exemption to supply these has been granted) representative of all batches of product seeking distribution in Australia.
    • At least 5 (five) vials (samples) of any further consignments of a manufacturing batch of Vaxneuvance vaccine with the Australian approved labels, PI and packaging (unless an exemption to supply these has been granted). Further consignments cover batches previously supplied to TGA for the purposes of batch release testing but are seeking to be supplied again.
    • If the manufacturing batch has been released in Europe or United Kingdom [UK] a copy of the EU [European Union] Official Control Authority Batch Release (OCABR) certificate (or equivalent from the UK) must be provided.
    • Any reagents, reference material and standards required to undertake testing, as requested by Laboratories Branch, TGA.

    Sponsors must provide all requested samples and data in sufficient time (at least five business days) prior to any distribution date to allow the TGA to perform testing and review. Distribution of each batch of vaccine is conditional upon fulfilment of these conditions and receipt of a letter from the Laboratories Branch acknowledging release.

  • Samples and data should be forwarded to the Biotherapeutics Section, Laboratories Branch before release of each batch and with sufficient lead time to allow for Laboratories Branch testing.
  • The shipments (including reagents) to TGA are the responsibility of the Australian sponsor/agent who will be required to facilitate the import and customs clearance process.

Certified Product Details

  • An electronic copy of the Certified Product Details (CPD) as described in Guidance 7: Certified Product Details of the Australian Regulatory Guidelines for Prescription Medicines (ARGPM) should be provided upon registration of the therapeutic good. In addition, an updated CPD, for the above products incorporating the approved changes is to be provided within one month of the date of approval letter. A template for preparation of CPD for biological prescription medicines and vaccines can be obtained from the TGA website. The CPD should be sent as a single bookmarked PDF document to vaccines@health.gov.au as soon as possible after registration/approval of the product or any subsequent changes as indicated above.
  • The Vaxneuvance EU[European Union]-risk management plan (RMP) (version 0.1, dated 2 November 2020, data lock point 16 September 2020), with Australian specific annex (version 0.1, dated 01 December 2020), included with submission PM-2020-06364-1-2, and any subsequent revisions, as agreed with the TGA will be implemented in Australia.

Vaxneuvance (Pneumococcal 15-valent conjugate vaccine [CRM197 protein], adsorbed) is to be included in the Black Triangle Scheme. The PI and CMI [Consumer Medicines Information] for Vaxneuvance must include the black triangle symbol and mandatory accompanying text for five years, which starts from the date that the sponsor notifies the TGA of supply of the product. An obligatory component of risk management plans is routine pharmacovigilance. Routine pharmacovigilance includes the submission of periodic safety update reports (PSURs). Unless agreed separately between the supplier who is the recipient of the approval and the TGA, the first report must be submitted to TGA no later than 15 calendar months after the date of the approval letter. The subsequent reports must be submitted no less frequently than annually from the date of the first submitted report until the period covered by such reports is not less than three years from the date of the approval letter. The annual submission may be made up of two PSURs each covering six months. If the sponsor wishes, the six monthly reports may be submitted separately as they become available. If the product is approved in the EU during the three years period, reports can be provided in line with the published list of EU reference dates no less frequently than annually from the date of the first submitted report until the period covered by such reports is not less than three years from the date of the approval letter. The reports are to at least meet the requirements for PSURs as described in the European Medicines Agency's Guideline on Good Pharmacovigilance Practices (GVP) Module VII-periodic safety update report (Rev 1), Part VII.B Structures and processes. Note that submission of a PSUR does not constitute an application to vary the registration. Each report must have been prepared within ninety calendar days of the data lock point for that report.

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