ACIP approves 2016 adult immunization schedule

The Advisory Committee on Immunization Practices (ACIP) has approved the recommended adult immunization schedule for 2016. The recommendations are published as a clinical guideline in the Feb. 2 issue of the Annals of Internal Medicine.

06 feb 2016--David K. Kim, M.D., from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues present changes to the 2016 adult immunization schedule from the 2015 schedule, based on new ACIP recommendations.
The researchers note that the major changes to the schedule relate to human papillomavirus (HPV), pneumococcal, and serogroup B meningococcal (MenB) vaccines. The nine-valent HPV vaccine was added to the schedule, and can be used for routine vaccination against HPV for males and females. For immunocompetent adults aged 65 years and older, the vaccine interval for 13-valent pneumococcal conjugate vaccine (PCV13) followed by 23-valent pneumococcal polysaccharide vaccine (PPSV23) was changed from "six to 12 months" to "at least one year." Immunocompromised adults, and those with anatomical or functional asplenia, cerebrospinal fluid leak, or cochlear implant, aged 19 years or older, should receive PPSV23 at least eight weeks after PCV13. All persons aged 10 years and older who are at increased risk for serogroup B meningococcal disease should have the MenB vaccine series.
"Only 29 percent of general internists and 32 percent of family physicians assess their patients' vaccination status at every visit," the authors write. "The health care provider is clearly the central figure in promoting vaccination among adults with high-risk conditions and adults in general."

More information: Full Text

2009 Adult Immunization Schedule Approved

11 jan 2009--Updated guidelines on vaccinating adults have been released by the Advisory Committee on Immunization Practices and appear in Annals of Internal Medicine.

No new vaccines have been added since last year, but some of the footnotes to existing vaccines have been revised. Among the changes:

• Smoking and asthma are now indications for the pneumococcal polysaccharide vaccine.
  
• A four-dose schedule is offered for the combined hepatitis A/hepatitis B vaccine.
  

In addition, the immunization schedule has been updated to clarify the following:

• Adults who've received only one dose of varicella vaccine should receive another.
  
• Occupational exposure to human papillomavirus vaccine does not place healthcare professionals at risk.
  

The American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and the American College of Physicians have all approved these guidelines.

LINK(S):

Immunization schedule in Annals of Internal Medicine (Free)

Annals of Internal Medicine editorial (Subscription required)

Panel Calls for Vaccine for Adult Smokers

ATLANTA, 23 oct 2008 -- For the first time, an influential government panel is recommending a vaccination specifically for smokers. The panel decided Wednesday that adult smokers under 65 should get pneumococcal vaccine. The shot -- already recommended for anyone 65 or older -- protects against bacteria that cause pneumonia, meningitis and other illnesses.
Federal officials usually adopt recommendations made by the panel, the Advisory Committee on Immunization Practices. The vote means more than 31 million adult smokers probably will soon be called on to get the shot.
Studies have shown that smokers are about four times more likely than nonsmokers to suffer pneumococcal disease. Also, the more cigarettes someone smokes each day, the higher the odds they'll develop the illnesses.
Why smokers are more susceptible is not known for sure, but some scientists believe it has to do with smoking-caused damage that allows the bacteria to more easily attach to the lungs and windpipe, said Dr. Pekka Nuorti, a medical epidemiologist with the Centers for Disease Control and Prevention.
Pneumococcal infections are considered the top killer among vaccine-preventable diseases. It's a common complication of influenza, especially in the elderly, and is considered responsible for many of the 36,000 annual deaths attributed to flu.
The committee voted 11 to 3 to pass the recommendation, with one member abstaining. The panel also added a call for smoking cessation counseling.
Some members said it might be more cost effective to recommend the vaccine for smokers who were at least age 40, because pneumococcal disease is relatively uncommon in younger smokers. Others at the meeting made the same argument.
Dr. James Turner, who oversees student health programs at the University of Virginia, said about one in five college students smoke but he has never seen a case of serious pneumococcal disease in a student body.
''I wonder how many young people are truly benefiting from this'' recommendation, said Turner, speaking as a representative of the American College Health Association.
The shot is less than perfect. First licensed in 1983, it is designed to protect against 23 strains of pneumococcal bacteria. But it hasn't proved very effective against pneumonia, and hasn't been very effective in warding off other pneumococcal illnesses in people with weakened immune systems and people age 80 or older.
It's to be given to smokers as a one-time dose with no booster, but its protection drops off after five to 10 years.
Made by Merck & Co., it's sold under the trade name Pneumovax and costs about $30 a dose.
A different vaccine -- Wyeth's Prevnar, which came on the market in 2000 -- is recommended for children under age 2, and for kids 2 to 5 with certain chronic conditions or who are at higher risk for illness.
Prevnar protects against seven strains of bacteria that were the most common causes of pneumococcal diseases at the time the vaccine was developed. But lately, those strains have stopped being important causes of illness. Experts have become concerned about dozens of other strains, including some that have flourished and become resistant to antibiotics.
Wyeth has been developing a new vaccine. It is expected to present study data on it at a scientific meeting later this month, and to apply for government licensing approval early next year.