ACIP immunization update

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Practice Alert

ACIP immunization update

J Fam Pract. 2010 March;59(3):155-158

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References

1. Centers for Disease Control and Prevention. Updated recommendations from the ACIP for use of hepatitis A vaccine in close contacts of newly arriving international adoptees. MMWR Morbid Mortal Wkly Rep. 2009;58:1006-1007.Available at: www.cdc.gov/mmwr/preview/mmwrhtml/mm5836a4.htm. Accessed January 19, 2010.

2. Centers for Disease Control and Prevention. Update: prevention of hepatitis A after exposure to hepatitis A virus and in international travelers. Updated recommendations of the ACIP. MMWR Morbid Mortal Wkly Rep. 2007;56:1080-1084.Available at: www.cdc.gov/mmwr/preview/mmwrhtml/mm5641a3.htm. Accessed January 19, 2010.

3. Centers for Disease Control and Prevention. Prevention of hepatitis A through active or passive immunization: recommendation of the ACIP. MMWR Recomm Rep. 2006;55(RR-7):1-23.Available at: www.cdc.gov/mmwr/preview/mmwrhtml/rr5507a1.htm. Accessed January 19, 2010.

4. ACIP provisional recommendations for the use of combination vaccines. August 28, 2009. Available at: www.cdc.gov/vaccines/recs/provisional/downloads/combo-vax-Aug2009-508.pdf. Accessed January 18, 2010.

5. ACIP provisional recommendations for use of measles, mumps, rubella and varicella (MMRV) vaccine. October 20, 2009. Available at: www.cdc.gov/vaccines/recs/provisional/downloads/mmrv-oct2009-508.pdf. Accessed January 19, 2010.

6. Centers for Disease Control and Prevention. Update recommendations of the ACIP regarding routine poliovirus vaccination. MMWR Morbid Mortal Wkly Rep. 2009;58:829-830.Available at: www.cdc.gov/mmwr/preview/mmwrhtml/mm5830a3.htm?s-cid=mr. Accessed January 20, 2010.

7. Centers for Disease Control and Prevention. Provider letter, July 30, 2009. Available at: www.cdc.gov/vaccines/vac-gen/shortages/downloads/Hib-hcp-ltr-7-30-09.pdf. Accessed February 15, 2010.

8. ACIP provisional recommendations for HPV vaccine. December 1, 2009. Available at: www.cdc.gov/vaccines/recs/provisional/downloads/hpv-vac-dec2009-508.pdf. Accessed January 18, 2010.

9. Centers for Disease Control and Prevention. Quadrivalent human papillomavirus vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2007;56(RR-2):1-24.Available at: http://www.cdc.gov/mmwr/pdf/rr/rr5602.pdf. Accessed February 2, 2010.

10. Meeting of the Advisory Committee on Immunization Practices. October 21-22, 2009, Atlanta, GA. Available at: www.cdc.gov/vaccines/recs/ACIP/livemeeting-Oct09.htm#hpv. Accessed January 21, 2010.

11. Campos-Outcalt D. The case for HPV immunization. J Fam Pract. 2009;58:660-664.

12. ACIP provisional recommendations for the prevention of human rabies. July 10, 2009. Available at: www.cdc.gov/vaccines/recs/provisional/downloads/rabies-July2009-508.pdf. Accessed January 28, 2010.

13. Centers for Disease Control and Prevention. Human rabies prevention—United States, 2008: Recommendations of the ACIP. MMWR Morbid Mortal Wkly Rep. 2008;57(early release):1-26, 28.Available at: www.cdc.gov/mmwr/preview/mmwrhtml/rr57e507a1.htm. Accessed January 28, 2010.

14. Advisory Committee on Immunization Practices summary report. June 24-26, 2009. Available at: http://www.cdc.gov/vaccines/recs/ACIP/downloads/min-jun09.pdf. Accessed January 28, 2010.

15. ACIP provisional recommendations for measles-mumps-rubella (MMR) “evidence of immunity” requirements for healthcare personnel. August 28, 2009. Available at:www.cdc.gov/vaccines/recs/provisional/downloads/mmr-evidence-immunity-Aug2009-508.pdf. Accessed January 28, 2010.

16. Centers for Disease Control and Prevention. Updated recommendation from ACIP for revaccination of persons at prolonged increased risk for meningococcal disease. MMWR Morb Mortal Wkly Rep. 2009;58:1042-1043.Available at: www.cdc.gov/mmwr/preview/mmwrhtml/mm5837a4.htm. Accessed January 20, 2010.

Meningococcal booster for those at high risk

ACIP now recommends quadrivalent meningococcal conjugate vaccine (MCV4) for all teens ages 11 to 18 years and for anyone 2 to 55 years of age who is at increased risk for meningococcal disease.¹⁶ MCV4 is licensed as a single dose.

FAST TRACK

ACIP now recommends that individuals previously vaccinated with either MCV4 or MPSV4 who are at prolonged increased risk be revaccinated with MCV4.

Because of the high risk for meningococcal disease among certain groups of people, as well as limited data on duration of protection, ACIP now recommends that individuals previously vaccinated with either MCV4 or meningococcal polysaccharide vaccine (MPSV4) who are at prolonged increased risk be revaccinated with MCV4.

Those who were previously vaccinated at 7 years of age or older should be revaccinated 5 years after their previous meningococcal vaccine; individuals who were previously vaccinated at ages 2 to 6 years should be revaccinated 3 years after their previous meningococcal vaccine.

Individuals at prolonged risk for meningococcal disease are those with complement component deficiencies or anatomic or functional asplenia, microbiologists who routinely work with Neisseria meningitides, and travelers to countries where meningococcal disease is hyperendemic or epidemic.

College freshmen living in dormitories who were previously vaccinated with MCV4 do not need to be revaccinated. However, college freshmen living in dormitories who were vaccinated with MPSV4 ≥5 years previously should be vaccinated with MCV4.

FAST TRACK

A new pneumococcal conjugate vaccine (PCV13) for infants and children will be licensed soon. It will replace the PCV7 vaccine now recommended routinely.

New pneumococcal vaccine with more coverage
A new pneumococcal conjugate vaccine (PCV13) for infants and children will be licensed soon. It will replace the PCV7 vaccine now recommended routinely. ACIP will make recommendations on how to introduce PCV13 into a schedule for infants and children who are in the middle of a PCV7 series, and for catch-up vaccination for children who have completed a PCV7 series.

The new vaccine will provide added protection against an additional 6 types of pneumococcal bacteria, and will replace the older product immediately after licensure. It is unclear what will become of unused supplies of PCV7. Physicians who need to order PCV7 in this interim period before the new vaccine is licensed will be faced with difficult choices. The options include ordering only small quantities or trying to get an advance commitment from the manufacturers to take back any unused vaccine.