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STRANGLES ( PINNACLE I.N.) INTRANASAL VACCINE 10 DOSES To help protect horses against strangles, look to PINNACLE® I.N. –the only two-dose, modified-live bacterial strangles vaccine developed to help prevent strangles caused by Streptococcus equi (S. equi).

Strangles is a highly contagious upper respiratory infection most common in young horses. Strangles symptoms can include fever, difficulty swallowing, abnormal breathing, nasal discharge, swelling and/or abscesses of the lymph nodes.1 The disease can spread quickly and is easily transmitted through direct animal-to-animal contact or by objects — buckets, bridles or human hands — that have come in contact with infected horses. Your horse may be at risk for strangles if he travels to events or shows or is exposed to unfamiliar horses, such as within a boarding barn.



  • The only two-dose modified-live vaccine developed to help prevent strangles caused by S. equi.
  • Intranasal administration helps provide a more natural immune response, stimulating innate andmucosal immunity at the site of natural infection.
  • PINNACLE I.N. utilizes a specially designed cannula that helps deliver the vaccine to the pharyngeal (throat) area.
  • Because it is given intranasally, PINNACLE I.N. avoids local injection-site reactions that can occur with parenteral S. equi vaccines.2

Dosing and Administration:

Aseptically rehydrate with the entire contents of the accompanying sterile diluent. Instill the entire rehydrated vaccine into one nostril using a syringe with applicator tip. Administer a second dose two to three weeks later. Annual revaccination is recommended.

For intranasal use only. Do not administer by any other route than intranasal.

Always read and follow label indications.


This product contains live bacteria and is designed for intranasal use only. Disinfect hands and equipment after use. Contamination of the user’s hands or equipment with reconstituted vaccine could lead to infections if proper disinfection practices are not followed prior to procedures that require asepsis. Injection equipment used to reconstitute or administer PINNACLE I.N. should not be reused, and should be disposed of appropriately. In case of anaphylactoid reaction, administer epinephrine. After administration, a small number of horses may experience noncontagious transitory upper respiratory signs including nasal discharge and lymphadenectasis. Purpura hemorrhagica may be seen in hypersensitive individuals following exposure to streptococcal proteins.

Store in the dark at 2° to 7°C (35° to 45°F). AVOID FREEZING. Shake well after rehydration. Do not vaccinate within 30 days before slaughter. Use entire contents when first opened. Burn container and all unused contents.

For veterinary use only.

AAEP Vaccine Recommendations:


Vaccination in the face of an outbreak should be carefully considered, as there is significantly increased risk of adverse reactions in exposed horses.  Purpura hemmorrhagica can be associated with vaccine administration. In a recent retrospective study of 53 horses with purpura hemorrhagica, 5 cases were vaccinated with a S. equi M protein vaccine. Outbreak mitigation and the prevention of spread of S. equi infection are centered on management of horses, personnel, and facilities.

(View AAEP Infectious Disease Control Guidelines—S. equi.; view ACVIM Strep equi consensus statement) 


Modified live vaccine:

STRANGLES ( PINNACLE I.N.) INTRANASAL VACCINE 10 DOSES  An intranasal product has been shown to stimulate a high level of immunity against experimental challenge. The inductive sites are the pharyngeal and lingual tonsils. Vaccinal organisms must reach these sites in sufficient numbers to trigger protective responses; therefore, accurate vaccine delivery is critical to vaccine efficacy. In a small percentage of cases, residual vaccinal organism virulence may result in formation of slowly developing mandibular or retropharyngeal abscesses. The risk of vaccine-associated adverse events is increased when the product is administered to young foals.

Maternal antibody interference with respect to the development of mucosal immunity needs to be studied further.

In order to avoid inadvertent contamination of other vaccines, syringes and needles, it is advisable and considered a good practice to administer all parenteral vaccines or other injectables before the handling and administration of the intranasal vaccine against S. equi.

Vaccination Schedules:

Adult horses previously vaccinated:  Vaccinate every 6 to 12 months based on risk assessment and manufacturers’ recommendations.

Adult horses unvaccinated or having unknown vaccinal history


Modified live vaccine:

Administer intranasally a 2-dose primary series with a 3-week interval between doses. Semiannual (6-month intervals) or annual revaccination is recommended.



Modified live vaccine:

Administer intranasally at 6 to 9 months of age a 2-dose primary series with a 3-week interval between doses. This vaccine has been safely administered to foals as young as 6 weeks of age when there is a high risk of infection, such as occurs during an outbreak, but the efficacy of its use in very young foals has not been adequately studied. If administered to young foals in this manner, a third dose of the modified live vaccine should be administered 2 to 4 weeks before the foal is weaned to optimize protection during that time of high risk of infection. The risk of vaccine-associated adverse events is increased when the product is administered to young foals.

Horses having been naturally infected and recovered:  Following recovery from strangles, most horses develop a durable immunity, persisting in over 75% of animals for 5 years or longer. This indicates that stimulation of a high level of immunity is biologically feasible given appropriate presentation of protective immunogens. Currently, a diagnostic test is available and may be used to assess the level of immunity conferred by natural exposure or vaccination. Since natural exposure or vaccination can provide variable levels of immunity, use of this test may provide a guideline in determining the need for current or future vaccination. Additional testing information is available from; ACVIM Strep equi consensus statement.


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