Multivalent pneumococcal polysaccharide-protein conjugate composition

1. A mixed carrier, multivalent pneumococcal conjugate composition, comprising different pneumococcal capsular polysaccharide-protein conjugates, wherein each pneumococcal capsular polysaccharide-protein conjugate comprises a protein carrier conjugated to a capsular polysaccharide from a different serotype of Streptococcus pneumoniae , wherein the Streptococcus pneumoniae serotypes are selected from 1, 3, 4, 5, 6A, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 18C, 19A, 19F, 22F, 23F, and 33F,

wherein the protein carrier is CRM 197 or tetanus toxoid, and

wherein two of the capsular polysaccharides are conjugated to tetanus toxoid and the remaining capsular polysaccharides are conjugated to CRM 197 , wherein the two capsular polysaccharides that are conjugated to tetanus toxoid are selected from the group consisting of serotypes 1, 3, and 5.

2. The mixed carrier, multivalent pneumococcal conjugate composition of claim 1 , wherein the capsular polysaccharides from serotypes 1 and 5 are conjugated to the tetanus toxoid, and the capsular polysaccharides from serotypes 3, 4, 6A, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 18C, 19A, 19F, 22F, 23F, and 33F are conjugated to CRM 197 .

3. The mixed carrier, multivalent pneumococcal conjugate composition of claim 1 , wherein the capsular polysaccharides from serotypes 1 and 3 are conjugated to the tetanus toxoid, and the capsular polysaccharides from serotypes 4, 5, 6A, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 18C, 19A, 19F, 22F, 23F, and 33F are conjugated to CRM 197 .

4. The mixed carrier, multivalent pneumococcal conjugate composition of claim 1 , wherein the capsular polysaccharides from serotypes 3 and 5 are conjugated to the tetanus toxoid, and the capsular polysaccharides from serotypes 1, 4, 6A, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 18C, 19A, 19F, 22F, 23F, and 33F are conjugated to CRM 197 .

5. The mixed carrier, multivalent pneumococcal conjugate composition of claim 1 , further comprising an adjuvant.

6. The mixed carrier, multivalent pneumococcal conjugate composition of claim 5 , wherein the adjuvant is an aluminum-based adjuvant.

7. The mixed carrier, multivalent pneumococcal conjugate composition of claim 6 , wherein the adjuvant is selected from the group consisting of aluminum phosphate, aluminum sulfate, and aluminum hydroxide.

8. The mixed carrier, multivalent pneumococcal conjugate composition of claim 7 , wherein the adjuvant is aluminum phosphate.

9. The mixed carrier, multivalent pneumococcal conjugate composition of claim 1 , wherein:

the capsular polysaccharide from serotype 9N is conjugated to CRM 197 in a state where the capsular polysaccharide from serotype 9N is activated to have a degree of oxidation of 2-19 or 5-10 and a molecular weight of 200-700 kDa;

the conjugate formed between the capsular polysaccharide from serotype 9N and CRM 197 has a molecular weight of 500-4,000 kDa;

a ratio (W/W) of the capsular polysaccharide from serotype 9N to CRM 197 in the conjugate formed between the capsular polysaccharide from serotype 9N and CRM 197 is 0.5-2.5; and/or

15-60% of the conjugate formed between the capsular polysaccharide from serotype 9N and CRM 197 has a K d of 0.3 or below in a CL-4B column.

10. A vaccine comprising the mixed carrier, multivalent pneumococcal conjugate composition of claim 1 and a pharmaceutically acceptable excipient.

11. The vaccine of claim 10 , wherein the 21 different pneumococcal capsular polysaccharide-protein conjugates consist of the capsular polysaccharides from serotypes 1 and 5, each of which is conjugated to the tetanus toxoid, and the capsular polysaccharides from serotypes 3, 4, 6A, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 18C, 19A, 19F, 22F, 23F, and 33F, each of which is conjugated to CRM 197 .

12. The vaccine of claim 11 , wherein the vaccine is formulated as a single 0.5 ml dose comprising 2 μg to 2.5 μg of each capsular polysaccharide except the capsular polysaccharide of serotype 6B, and 4 μg to 5 μg of capsular polysaccharide from serotype 6B.

13. The vaccine of claim 12 , wherein the vaccine is formulated as a single 0.5 ml dose comprising 2.2 μg of each capsular polysaccharide except the capsular polysaccharide of serotype 6B, and 4.4 μg of capsular polysaccharide from serotype 6B.

14. The vaccine of claim 11 , wherein the vaccine is formulated as a single 0.5 ml dose comprising 2 μg to 2.5 μg of each capsular polysaccharide from serotypes 1, 5, 6A, 7F, 8, 9N, 10A, 11A, 12F, 14, 15B, 18C, 22F, 23F, and 33F and 4 μg to 5 μg of each capsular polysaccharide from serotypes 3, 4, 6B, 9V, 19A, and 19F.

15. The vaccine of claim 14 , wherein the vaccine is formulated as a single 0.5 ml dose comprising 2.2 μg of each capsular polysaccharide from serotypes 1, 5, 6A, 7F, 8, 9N, 10A, 11A, 12F, 14, 15B, 18C, 22F, 23F, and 33F and 4.4 μg of each capsular polysaccharide from serotypes 3, 4, 6B, 9V, 19A, and 19F.

16. The vaccine of claim 11 , wherein the vaccine is formulated as a single 0.5 ml dose comprising 2.2 μg of each capsular polysaccharide except for up to six serotypes selected from the group consisting of serotypes 1, 3, 4, 5, 6B, 9V, 19A, and 19F, and 4.4 μg of each capsular polysaccharide from the up to six serotypes selected from the group consisting of serotypes 1, 3, 4, 5, 6B, 9V, 19A, and 19F.

17. The vaccine of claim 11 , wherein the vaccine is formulated as a single 0.5 ml dose comprising:

2 μg to 2.5 μg of each capsular polysaccharide except for serotype 6B;

4 μg to 5 μg of capsular polysaccharide from serotype 6B;

2 μg to 25 μg of tetanus toxoid;

40 μg to 75 μg of CRM 197 ;

0.125 to 0.250 mg of elemental aluminum adjuvant;

sodium chloride; and

a succinate buffer.

18. The vaccine of claim 17 , further comprising polysorbate 80.

19. The vaccine of claim 17 , wherein the elemental aluminum adjuvant comprises aluminum phosphate.

20. The vaccine of claim 17 , comprising 2.2 μg of each capsular polysaccharide except for serotype 6B and 4.4 μg of capsular polysaccharide from serotype 6B.

21. A method for prophylaxis of Streptococcus pneumoniae infection or disease caused by Streptococcus pneumoniae infection in a subject, the method comprising administering a prophylactically effective amount of the vaccine of claim 11 to the subject.

22. The method of claim 21 , wherein the subject is a human who is at least 50 years old and the disease is pneumonia or invasive pneumococcal disease (IPD).

23. The method of claim 21 , wherein the subject is a human who is at least 6 weeks old and the disease is pneumonia, invasive pneumococcal disease (IPD), or acute otitis media (AOM).

24. The method of claim 23 , wherein the subject is 6 weeks to 5 years of age, 2 to 15 months of age, or 6 to 17 years of age.

25. The method of claim 21 , wherein the subject is a human.

26. The method of claim 21 , wherein the vaccine is administered by intramuscular injection.

27. The method of claim 21 , wherein the vaccine is administered as part of an immunization series.

28. A method for prophylaxis of Streptococcus pneumoniae infection or disease caused by Streptococcus pneumoniae infection in a subject, the method comprising administering a prophylactically effective amount of the mixed carrier, multivalent pneumococcal conjugate composition of claim 1 to the subject.

29. A method for prophylaxis of Streptococcus pneumoniae infection or disease caused by Streptococcus pneumoniae infection in a human subject, the method comprising administering a prophylactically effective amount of the vaccine of claim 20 to the human subject.

30. A method for prophylaxis of Streptococcus pneumoniae infection or disease caused by Streptococcus pneumoniae infection in a human subject, the method comprising administering a prophylactically effective amount of the vaccine of claim 10 to the human subject.