What’s the right amount of the childhood vaccine Prevnar? A study published in JAMA today suggests that three doses may be as effective as the four doses that are standard in the U.S. and many other countries. Private insurers pay $83 per dose for Prevnar in the U.S., so the cost of that fourth dose adds up. It’s the best-selling vaccine in the world and generated $2.7 billion in sales for its manufacturer, Wyeth, last year. The vaccine’s success caught the eye of Pfizer, which is in the process of buying Wyeth for a deal originally valued at about $68 billion. But both Wyeth and the CDC signaled that U.S. recommendations for administering Prevnar aren’t likely to change anytime soon. CDC says the current schedule for Prevnar – three doses in an infant’s first 12 months, followed by a booster shot — has substantially reduced rates of pneumococcal disease since the shot’s introduction in 2000. Wyeth notes that the Prevnar dosing schedule matches that for other childhood vaccines. The study published in JAMA was conducted

among about 1,000 infants in the Netherlands, funded by that country’s Ministry of Health. It found that giving Prevnar in two initial doses followed by a booster shot reduced the carriage rate for the targeted bacteria by about 60% at two years of follow up, versus unvaccinated kids. The study’s authors say that’s comparable to what the 3-plus-1 regimen achieved in other studies. “In my opinion you could safely go to two-plus-one,” Elisabeth Sanders, one of the study’s co-authors and professor of pediatric immunology and infectious diseases at University Medical Center Utrecht in the Netherlands, told Dow Jones Newswires. “Why not save the one injection if it’s not required?” Reduced dosing could save money and make it easier to expand Prevnar vaccination in developing countries, where pneumococcal diseases can be particularly deadly, the study’s authors say. And some countries in the developed world, including the U.K. and Norway, are already on a 2-plus-1 schedule.

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Less Prevnar May Be Just As Good. Don’t Expect Changes Soon.