Spring 2016 Issue
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Meeting of the Advisory Committee
on Immunization Practices
By Stan Grogg, DO
October 21, 2015
Centers for Disease Control and Prevention
Stan Grogg, DO
- 2016 Child and Adolescent Immunization Schedules. ACIP voted to approve the new schedule for 2016 and will be reviewed by AAP, AAFP, and ACOG. Recommendations should be completed by Jan 16, 2016.
- Major changes:
- A new chart for vaccines’ order of schedule has been developed.
- Meningococcal B vaccine has been added.
- The two types of MEN B are NOT interchangeable.
- 2016 Adult Immunization Schedule (ACIP recommended to approve the adult vaccine schedule)
- To be reviewed and approved by AAFP, ACP, ACOG and ACNM then published in MMWR and Internal Medicine Journal in January 2016. www.cdc.gov/vaccines/hcp/acip-recs/index.html
- Proposed changes:
- Adding information on females aged 19-26 years concerning 2vHPV, 4vHPV, or 9vHPV
- Males 19-21 years, three dose series of 4vHPV or 9vHPV is recommended
- Pneumococcal vaccine
- Interval between PCV13 and PPSV23 vaccines for adults aged ≥65 years > 1 year.
- Adults aged 19–64 years with immunocompromising conditions for whom pneumococcal vaccines are recommended, PCV13 should be separated by PPSV23 by 8 weeks.
- HepB: Persons with end-stage renal disease should receive Hep B.
- Serogroup B meningococcal vaccines: among young adults who are at increased risk for serogroup B meningococcal disease will be added.
- Meningococcal Vaccines: Serogroup MEN C outbreak occurred in men who have sex with men (MSM), Chicago, 2015 (seven cases)
- Epidemiology and Surveillance Update
- Oct. 2015. 1.2 % tested were positive for influenza (activity low).
- Presently A-H3N2 is mostly predominant.
- N. Hemisphere influenza vaccine should offer protection against the majority of circulating viruses analyzed to date.
- Sanofi Pasteur conducted an economic analysis which demonstrated the cost-effectiveness of high-dose trivalent inactivated influenza vaccine for persons 65 years of age and older (Fluzone about $12.06 vs $30.00)
- Adjuvanted trivalent inactivated influenza vaccine
- Produced by Seqirus (the new entity formed between bioCSL and NVS Influenza Vaccines, which was formerly the influenza vaccine division of Novartis)
- Generated higher antibody titers and was well tolerated with acceptable safety profile compared to other licensed vaccines
- Pediatric quadrivalent aTIV adjuvant is under study
- Human Papillomavirus (HPV) Vaccines
- National HPV vaccination coverage increased slightly in 2014
- HCP recommendation is important
- Update on HPV vaccine safety continues to show no increased concerns
- >85% managed care plans decided to cover 9vHPV
- Plan to study two dose vs three dose for 9vHPV
- Japanese Encephalitis (JE) Vaccine
- Co-administration with rabies vaccine (Rabipur) is ok
- Alternative dosing schedule with one week interval works
- May be given with rabies vaccine concomitantly.
- Appears to be safe
- Combination Vaccine
- A new Investigational hexavalent pediatric vaccine under review by FDA (DTaP-IPV-Hib-HepB; Merck and Sanofi Pasteur). A Biologics License Application (BLA) for this hexavalent pediatric vaccine was accepted by FDA for review in October 2014.
- Expect FDA approval by end of 2015.
- Cholera Vaccine
- PaxVax has introduced CVD 103-HgR as an oral cholera vaccine that is anticipated to be licensed in the US in 2016.
- Ebola Vaccine Trial Update: a new vaccine under study appears very efficacious and safe.
- Vaccine Supply (http://www.cdc.gov/vaccines/vac-gen/shortages/default.htm?s_cid=cs_000).
Next ACIP meeting: February 24-25, 2016. http://www.cdc.gov/vaccines/acip/meetings/upcoming-dates.html.
ACIP information: http://www.cdc.gov/vaccines/acip/meetings/meetings-info.html.