What's Changed in Immunization Recommendations From CDC Advisory Committee
The Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) has issued new recommendations on immunizations, including influenza, serogroup B meningococcal, and human papillomavirus (HPV) vaccination.
While the ACIP is continuing to recommend that all persons aged ≥6 months receive an annual vaccination against influenza, the Committee did not renew the previous year's preference for using the intranasal spray influenza vaccine (eg, LAIV) instead of the influenza vaccine injection (eg, IIV) in healthy children aged 2–8 when immediately available. The previous recommendation was based on data that suggested that the intranasal spray vaccine may offer superior protection for children in this age group. The decision to not renew this recommendation was based on new data from more recent influenza seasons which have not confirmed these previous findings. The ACIP now recommends an annual influenza vaccine for children aged ≥6 months with no preference states for either formulation.
The ACIP also voted to recommend serogroup B meningococcal vaccination for individuals ≥10 years of age at increased risk for meningococcal disease, including those with persistent complement component deficiencies, with anatomic or functional asplenia, microbiologists routinely exposed to isolates of Neisseria meningitides, and individuals identified to be at increased risk because of a serogroup B meningococcal disease outbreak. In October 2014, Pfizer's Trumenba (Meningococcal Group B Vaccine) was granted accelerated approval by the Food and Drug Administration (FDA) for active immunization to prevent invasive disease caused by Neisseria meningitidis serogroup B in individuals 10–25 years of age.
In addition, Gardasil 9 (9-valent human papillomavirus types, recombinant; Merck) has been added to the routine recommendations for vaccination of females and males 11–12 years of age. The vaccination series can be started at age nine. Vaccination is also recommended for females aged 13–26 and for males aged 13–21 who have not been vaccinated previously or have not completed the 3-dose series. The ACIP also recommends that if vaccination providers do not know or do not have available the HPV vaccine previously administered, or are in settings transitioning to Gardasil 9, for protection against HPV 16 and 18 any HPV vaccine may be used to continue or complete the series for females; Gardasil or Gardasil 9 may be used to continue or complete the series for males. The ACIP also voted to include Gardasil 9 in the CDC's Vaccines for Children (VFC) program for both boys and girls. Gardasil 9 was approved by the FDA in December 2014 for use in girls and young women 9–26 years of age for the prevention of cervical, vulvar, vaginal, and anal cancers caused by HPV types 16, 18, 31, 33, 45, 52 and 58, pre-cancerous or dysplastic lesions caused by HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58, and genital warts caused by HPV types 6 and 11. Gardasil 9 is also approved for use in boys 9–15 years of age for the prevention of anal cancer caused by HPV types 16, 18, 31, 33, 45, 52 and 58, precancerous or dysplastic lesions caused by HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58, and genital warts caused by HPV types 6 and 11. Gardasil 9 is not approved by the FDA for use in males 16 years of age and above.
The ACIP recommendations will be forwarded to the director of the CDC and the U.S. Department of Health and Human Services for review and approval. Once approved, the recommendations will be published in the Morbidity and Mortality Weekly Report (MMWR). In regards to the use of Gardasil 9 in prior HPV vaccine recipients, the ACIP will consider and vote on this policy at a future meeting.