Vaccines Archives - MPR

2023 Vaccination Schedule: Adults

Haymarket Media — Thu, 16 Feb 2012 18:00:00 +0000

2023 Vaccination Schedule-Adults

2023 VACCINATION SCHEDULE: ADULTS
This schedule indicates the recommended age groups and medical indications for routine administration of currently licensed vaccines for persons ≥19yrs. Licensed combination vaccines may be used whenever any components of the combination are indicated and when the vaccine’s other components are not contraindicated.
Recommended vaccination for adults who meet age requirement, lack documentation of vaccination, or lack evidence of past infection	Recommended vaccination for adults with an additional risk factor or another indication			Recommended vaccination based on shared clinical decision-making
Vaccine	19–26yrs	27–49yrs			50–64yrs	≥65yrs
COVID-19¹²	1 or 2 bivalent doses (see footnote 12)
Influenza inactivated (IIV4) or Influenza recombinant (RIV4)¹ OR	1 dose annually OR
Influenza live attenuated (LAIV4)¹	1 dose annually
Tetanus, diphtheria, pertussis (Tdap or Td)²	1 dose Tdap each pregnancy; 1 dose Td/Tdap for wound management (see footnote 2)
Tetanus, diphtheria, pertussis (Tdap or Td)²	1 dose Tdap, then Td or Tdap booster every 10yrs
Measles, mumps, rubella (MMR)³	1 or 2 doses (if born in 1957 or later) For healthcare personnel, see footnote 3
Varicella (VAR)⁴	2 doses (if born in 1980 or later)		2 doses
Zoster recombinant (RZV)⁵	2 doses for immunocompromising conditions (see footnote 5)				2 doses
Human papillomavirus (HPV)⁶	2 or 3 doses	27–45yrs
Pneumococcal (PCV15, PCV20, PPSV23) ⁷	1 dose PCV15 then PPSV23 OR					See footnote 7
Pneumococcal (PCV15, PCV20, PPSV23) ⁷	1 dose PCV20 (see footnote 7)					See footnote 7
Hepatitis A (HepA)⁸	2, 3, or 4 doses
Hepatitis B (HepB)⁹	2, 3, or 4 doses
Meningococcal A, C, W, Y (MenACWY)¹⁰	1 or 2 doses (for booster, see footnote 10)
Meningococcal B (MenB)¹⁰	2 or 3 doses (for booster, see footnote 10)
Meningococcal B (MenB)¹⁰	19–23yrs
Haemophilus influenzae type b (Hib)¹¹	1 or 3 doses

1. Influenza vaccination • For persons ≥19yrs, give 1 dose of any age and health status-appropriate influenza vaccine annually. • For persons ≥65yrs, give 1 dose of high-dose IIV4 (HD-IIV4), RIV4, or adjuvanted llV4 (aIIV4) influenza vaccine annually. Give any age-appropriate vaccine if none of these are available. • Persons with hives-only allergy to eggs should receive 1 dose of any appropriate vaccine. For allergy other than hives (eg, angioedema, respiratory distress), give in a medical setting under supervision of healthcare provider if using a vaccine other than RIV4 or ccIIV4. Persons with a previous severe allergic reaction to any influenza vaccine is contraindicated for future vaccination. • Do not give if person has a history of Guillain-Barre syndrome within 6wks after previous influenza vaccine dose, unless benefits outweigh risks. 2. Tetanus, diphtheria, and acellular pertussis (Tdap or Td) vaccination • Persons who previously did not receive a dose of Tdap at or after age 11yrs should receive 1 dose of Tdap vaccine, followed by Td or Tdap booster every 10yrs. • Persons who previously did not receive primary series for tetanus, diphtheria, and pertussis should receive at least 1 dose of Tdap, followed by 1 dose Td or Tdap ≥4wks after, and another Td or Tdap dose 6–12mos after last Td or Tdap (Tdap can be substituted for any Td dose, but preferred as first dose); Td or Tdap booster every 10yrs thereafter. • Give 1 dose of Tdap vaccine to pregnant women during each pregnancy (preferred during the early part of gestational weeks 27−36). • For wound management in persons with ≥3 doses of tetanus-toxoid-containing vaccine, give Tdap or Td for clean and minor wounds if >10yrs since last dose of tetanus-toxoid-containing vaccine. For all other wounds, give Tdap or Td if >5yrs since last dose of tetanus vaccine. Tdap is preferred if no or unknown history of Tdap vaccination, or in pregnancy. 3. Measles, mumps, rubella (MMR) vaccination • Adults with no evidence of immunity to measles, mumps, or rubella should receive 1 dose of MMR vaccine. • Evidence of immunity includes any of the following: — Born before 1957 (except healthcare personnel) — Documentation of receipt of MMR vaccine — Lab evidence of immunity or disease (documentation of provider-diagnosed disease without lab confirmation is not considered evidence of immunity) • Healthcare personnel born in 1957 or later with no evidence of immunity to measles, mumps, or rubella should receive 2-dose series ≥4wks apart for measles or mumps, or ≥1 dose for rubella. If born before 1957 with no evidence of immunity, consider 2-dose series ≥4wks apart for measles or mumps, or 1 dose for rubella. • MMR is contraindicated during pregnancy. Give 1 dose after birth and before hospital discharge. Nonpregnant women of childbearing age with no evidence of immunity to rubella should receive 1 dose of MMR. • Give 2-dose series ≥4wks apart to persons with HIV and CD4 percentages ≥15% and CD4 count ≥200cells/μL for ≥6mos with no evidence of immunity. MMR is contraindicated in HIV with CD4 percentage <15%, CD4 count <200 cells/µL, or other severe immunocompromising conditions. • Students in postsecondary educational institutions, international travelers, and household contacts of immunocompromised persons should receive 2 doses ≥4wks apart (or 1 dose if previously received 1 MMR dose). • In mumps outbreak settings, see www.cdc.gov/mmwr/volumes/67/wr/mm6701a7.htm for guidelines about additional doses of MMR, including 3rd dose. 4. Varicella vaccination • All adults without evidence of immunity to varicella should receive 2 doses of VAR vaccine 4–8wks apart. If previously received 1 dose of varicella-containing vaccine, give the 2nd dose at least 4wks after the 1st dose. • Evidence of immunity to varicella in adults includes any of the following: — documentation of 2 doses of varicella vaccine at least 4wks apart; — U.S.-born before 1980, except HCPs and pregnant women — diagnosis or verification of history of varicella or herpes zoster by a HCP; — lab evidence of immunity or disease. • VAR is contraindicated during pregnancy. Pregnant women without evidence of immunity should receive the first of 2 doses (4–8wks apart) or the 2nd dose, if previously received 1 dose, after birth and before hospital discharge. • HCP without evidence of immunity should receive 2 doses 4–8wks apart or the 2nd dose if previously received 1 dose. • Persons with HIV and CD4 percentages ≥15% and CD4 count ≥200cells/μL with no evidence of immunity may consider 2 doses 3mos apart. VAR is contraindicated in HIV with CD4 percentage <15%, CD4 count <200 cells/µL, or other severe immunocompromising conditions. 5. Zoster (recombinant zoster vaccine [RZV]) vaccination • All persons ≥50yrs and those 19–49yrs with immunocompromising conditions (including HIV regardless of CD4 count) should receive 2 doses of RZV 2–6mos apart (repeat dose if given <4wks apart). • Serologic evidence of prior varicella is not necessary for RZV vaccination. If evidence of varicella susceptibility becomes available, ACIP guidelines for varicella vaccination should be followed first. • If there is no documented history of varicella, varicella vaccination, or herpes zoster in persons ≥19yrs with immunocompromising conditions, refer to www.cdc.gov/mmwr/volumes71/wr/mm7103a2.htm for further guidance. • Consider delaying RZV until after pregnancy, if indicated. 6. Human papilloma virus (HPV) vaccination • Vaccinate all adults through age 26yrs. Can vaccinate adults age 27–45yrs based on shared clinical decision-making. • If initiated vaccination at ≥15yrs, give a 3-dose series at 0, 1–2, and 6mos; the 1st and 2nd doses should be at least 4wks apart, the 2nd and 3rd doses at least 12wks apart, and the 1st and 3rd doses at least 5mos apart; repeat doses if given too soon. • If initiated vaccination at 9–14yrs and received 1 dose or 2 doses <5mos apart, give 1 dose. No additional dose is needed if initiated vaccination at 9–14yrs and received 2 doses at least 5mos apart. • Persons with immunocompromising conditions, including HIV, should get a 3-dose series, even if initiated vaccination at 9–14yrs. • Series does not need to be restarted if vaccination schedule is interrupted. • No additional doses needed if valid vaccination series completed with any HPV vaccine. • HPV vaccination is not recommended until after pregnancy. However, pregnancy testing is not needed before vaccination. If a woman is vaccinated while pregnant, no intervention is needed. 7. Pneumococcal (15-valent and 20-valent pneumococcal conjugate vaccines [PCV15, PCV20] and 23-valent pneumococcal polysaccharide vaccine [PPSV23]) vaccination • All adults ≥65yrs and those 19–64yrs with certain underlying medical conditions or risk factors who have not previously received a dose of PCV13, PCV15, or PCV20, have previously received only PCV7, or whose previous vaccination history is unknown should receive 1 dose PCV15 or 1 dose PCV20. If PCV15 is used, 1 dose of PPSV23 should be given ≥1yr after PCV15 (≥8wks between doses of PCV15 and PPSV23 can be considered for immunocompromising conditions, cochlear implant, or cerebrospinal fluid leak). • Adults ≥65yrs and those 19–64yrs with certain underlying medical conditions or risk factors who previously received only PCV13 should receive 1 dose PCV20 ≥1yr after PCV13 dose or complete the recommended PPSV23 series. • Adults ≥65yrs and those 19–64yrs with certain underlying medical conditions or risk factors who previously received only PPSV23 should receive 1 dose PCV15 or 1 dose PCV20 ≥1yr after PPSV23. PCV15 dose does not need to be followed by another PPSV23 dose. • If previously received both PCV13 and PPSV23 but PPSV23 was given at age <65yrs, give 1 dose PCV20 ≥5yrs after the last pnuemococcal vaccine dose or complete the recommended PPSV23 series. • If previously received both PCV13 and PPSV23 and PPSV23 was given at age ≥65yrs, can give 1 dose PCV20 ≥5yrs after the last pneumococcal vaccine dose based on shared clinical decision- making. • Adults 19–64yrs with certain underlying medical conditions or risk factors who previously received both PCV13 and PPSV23 but have not completed the recommended series should receive 1 dose PCV20 ≥5yrs after the last pneumococcal vaccine dose or complete the recommended PPSV23 series. • Immunocompromising conditions and underlying medical conditions or other risk factors include chronic renal failure, nephrotic syndrome, immunodeficiency, iatrogenic immunosuppression, generalized malignancy, HIV, Hodgkin disease, leukemia, lymphoma, multiple myeloma, solid organ transplants, congenital or acquired asplenia, sickle cell disease, other hemoglobinopathies, alcoholism, chronic heart/liver/lung disease, cigarette smoking, cochlear implant, CSF leak, diabetes. 8. Hepatitis A vaccination • Vaccinate any not at risk person seeking protection from hepatitis A virus (HAV) infection and persons with any of the following indications: — chronic liver disease (hepatitis B/C, cirrhosis, fatty or alcoholic liver disease, autoimmune hepatitis, ALT/AST >2xULN); — HIV infection; — men who have sex with men; — injection or non-injection drug use; — homelessness; — work with HAV in research lab or nonhuman primates with HAV infection; — travel to countries with high or intermediate endemic hepatitis A; — close personal contact with international adoptee (eg, household, regular babysitting) in 1st 60 days after arrival from country with high or intermediate endemic hepatitis A (give 1st dose as soon as adoption is planned, at least 2wks before adoptee’s arrival); — Pregnancy (if at risk for infection or severe outcome); — Settings for exposure (eg, drug use clinics, group homes, day care facilities for persons with developmental disabilities) • Give either a 2-dose series of the single antigen HepA vaccine (Havrix 6–12mos apart or Vaqta 6–18mos apart), or a 3-dose series of the HepA-HepB vaccine combination (Twinrix at 0, 1, and 6mos; the 1st and 2nd doses should be ≥4wks apart, and the 2nd and 3rd doses ≥5mos apart). • For travel in highly or intermediately endemic countries, Twinrix may be given on an accelerated schedule of 3 doses at 0, 7, and 21–30 days, followed by a booster at 12mos. 9. Hepatitis B vaccination • Vaccinate any person age 19–59yrs and those ≥60yrs with known HBV risk factors with a 2-, 3- or 4-dose series. Persons ≥60yrs without known risk factors may be vaccinated. Risk factors for HBV infection include: — HCV infection or chronic liver disease (cirrhosis, fatty or alcoholic liver disease, autoimmune hepatitis, ALT/AST >2xULN); — HIV-infection; — sexual exposure risk (eg, sex partners of HBsAg-positive persons, sexually active persons who are not in a mutually monogamous relationship, persons seeking evaluation or treatment for an STD, men who have sex with men); — current or recent injection drug use; — percutaneous or mucosal risk for blood exposure (eg, household contacts of HBsAg-positive persons, residents/staff of facilities for persons with developmental disabilities, HCPs and public safety workers who are exposed to blood or blood-contaminated body fluids, dialysis patients, patients <60yrs with diabetes [shared clinical decision-making for ≥60yrs]); — incarcerated; — travel to countries with high or intermediate hepatitis B endemicity — pregnancy (if at risk for infection or severe outcome. Heplisav-B and PreHevbrio are not recommended due to lack of safety data in pregnant persons) • Give the 2-dose series with Heplisav-B at least 4wks apart (2-dose series HepB only applies when 2 doses of Heplisav-B are used). • Give the 3-dose series with single-antigen HepB vaccines (Engerix-B, PreHevbrio, Recombivax HB) at 0, 1 and 6mos; the 1st and 2nd doses should be ≥4wks apart, the 2nd and 3rd doses ≥8wks apart, and the 1st and 3rd doses ≥16wks apart. If the combined HepA and HepB vaccine (Twinrix) is used, give 3 doses at 0, 1, and 6mos; the 1st and 2nd doses should be ≥4wks apart, and the 2nd and 3rd doses at least ≥5mos apart. • Give the 4-dose series of Twinrix on an accelerated schedule of 3 doses at 0, 7, and 21-30 days, followed by a booster at 12mos. • Dialysis patients should complete a 3-dose series with Recombivax HB at 0, 1, and 6mos or a 4-dose series with Engerix-B at 0, 1, 2 and 6mos. 10. Meningococcal (Serogroups A, C, W, and Y [MenACWY] or serogroup B [MenB]) vaccination • MenACWY vaccination (Menactra, Menveo, MenQuadfi): — Adults with anatomical or functional asplenia, HIV, persistent complement component deficiency, or on eculizumab or ravulizumab therapy should receive 2 doses of MenACWY at least 8wks apart. Revaccinate with 1 dose every 5yrs if risk remains. — microbiologists routinely exposed to N. meningitidis and persons traveling in countries where meningococcal disease is hyperendemic or epidemic should receive 1 dose of MenACWY; revaccinate every 5yrs if risk remains — first-year college students in residential housing (if not received vaccine at ≥16yrs) and military recruits should receive 1 dose of MenACWY. • MenB vaccination (Bexsero, Trumenba): — young adults 16–23yrs (16–18yrs preferred) not at increased risk may receive, based on shared clinical decision making, 2 doses of Bexsero at least 1 month apart, or 2 doses of Trumenba at least 6mos apart (if 2nd dose given too soon, give 3rd dose at least 4mos after 2nd dose). — adults with anatomic or functional asplenia, persistent complement component deficiency, on eculizumab or ravulizumab therapy, or microbiologists routinely exposed to N. meningitidis should receive 2 doses of Bexsero at least 1 month apart, or 3 doses of Trumenba at 0, 1–2, and 6mos (3rd dose is not needed if 2nd dose was given ≥6mos after 1st dose; if 3rd dose was given <4mos after 2nd dose, a 4th dose should be given ≥4 mos after 3rd dose). Give 1 dose of MenB booster 1yr after primary series and revaccinate every 2–3yrs if risk remains. — delay MenB until after pregnancy unless at increased risk and benefit outweighs potential risks. — The two MenB vaccines are not interchangeable. • Additional information on MenACWY and MenB booster doses in special situations is available at https://www.cdc.gov/mmwr/volumes/69/rr/rr6909a1.htm. *11. Haemophilus influenzae* type b (Hib) vaccination • 1 dose of Hib vaccine should be administered to persons with functional or anatomic asplenia, sickle cell disease or are undergoing elective splenectomy if they have not previously received Hib vaccine. Hib should be administered ≥14 days before splenectomy. • Recipients of a hematopoietic stem cell transplant should be vaccinated with a 3-dose regimen 6–12mos after a successful transplant, regardless of vaccination history; at least 4wks should separate doses. 12. Covid-19 vaccination • All unvaccinated adults and those who previously received only monovalent vaccine doses should receive 1 bivalent mRNA vaccine dose. Adults ≥65yrs may receive 1 additional bivalent mRNA vaccine dose ≥4mos after the first bivalent dose. Bivalent dose should be given ≥8wks after the last monovalent dose. • The monovalent Novavax vaccine remains authorized for use as a 2-dose primary series and as a booster in certain limited situations to adults who previously completed primary vaccination with any FDA authorized vaccine and have not received a previous booster dose, are unable or unwilling to receive an mRNA booster and would otherwise not receive a booster dose. • Monovalent formulations of mRNA vaccines should no longer be used for vaccination. The Janssen vaccine is no longer available in the US. • For a list of currently available COVID-19 vaccines and other recommendations for COVID-19 vaccination including dosing for immunocompromised adults, see https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html. 13. Polio vaccination • Routine polio vaccination is not recommended. • In adults at increased risk of exposure with no evidence of a complete polio series (eg, ≥3 doses), give remaining doses to complete the series. If has evidence of completed series, may give one lifetime IPV booster. 14. Additional information** • Immunocompromising conditions: Inactivated vaccines generally are acceptable (eg, pneumococcal, meningococcal, and inactivated influenza vaccine), and live vaccines generally are avoided in persons with immune deficiencies or immunocompromising conditions. Information on specific conditions is available at https://www.cdc.gov/vaccines/schedules/hcp/imz/adult-conditions.html. • Information on travel vaccine requirements and recommendations (eg, for hepatitis A and B, meningococcal, and other vaccines) available at http://wwwnc.cdc.gov/travel/destinations/list.
CHANGES IN THE SCHEDULE SINCE LAST RELEASE
• The HepB footnote was updated to add the 3-dose series for PreHevbrio. Recommendations for age ≥60yrs with or without known risk factors were also added. • The influenza footnote was updated to note the preferred vaccines for those age ≥65yrs and that live attenuated vaccine should not be administered to close contacts of immunosuppressed persons. • The MMR footnote was updated to include recommendations for additional doses in a mumps outbreak. • The meningococcal B footnote was updated to add guidance regarding a 4th dose of Trumenba. • The pneumococcal footnote has been substantially updated with recommendations for PCV15 and PCV20. • A poliovirus footnote was added to address adults who are at increased risk for exposure. • The zoster footnote was updated to provide guidance for those with evidence of prior varicella susceptibility and those with immunocompromising conditions.
REFERENCES
For information on individual vaccines, please see product monographs at www.eMPR.com, contact company for full labeling, or call the National Immunization Hotline at (800) 232-4636. Source: Advisory Committee on Immunization Practices (ACIP). Adult Immunization Schedule by Age: Recommendations for Ages 19 Years or Older, United States, 2023. https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html. Accessed May 9, 2023. Centers for Disease Control and Prevention. Interim Clinical Considerations for Use of COVID-19 Vaccines in the United States. Updated May 12, 2023. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html. Accessed May 22, 2023. Murthy N, Wodi AP, McNally V, Cineas S, Ault K. Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older — United States, 2023. MMWR Morb Mortal Wkly Rep. 2023;72:141–144. DOI: http://dx.doi.org/10.15585/mmwr.mm7206a2. (Rev. 5/2023)

2024 Catch-Up Vaccination Schedule: 4 Months-18 Years

Haymarket Media — Thu, 01 Mar 2012 21:00:00 +0000

2024 Catch-Up Vaccination Schedule: 4 Months-18 Years

2024 CATCH-UP VACCINATION SCHEDULE: 4 MONTHS−18 YEARS*
Vaccine	Minimum Age for Dose 1	Minimum Interval Between Doses
Vaccine	Minimum Age for Dose 1	Dose 1 to Dose 2	Dose 2 to Dose 3	Dose 3 to Dose 4	Dose 4 to Dose 5
Persons Aged 4 Months−6 Years
HepB¹	Birth	4 weeks	8 weeks and at least 16wks after 1st dose; minimum age for the final dose is 24wks
RV ²	6 weeks maximum age 14wks, 6 days for 1st dose	4 weeks	4 weeks maximum age 8mos, 0 days for final dose
DTaP³	6 weeks	4 weeks	4 weeks	6 months	6 months³
Hib⁴	6 weeks	4 weeks if 1st dose given before 1st birthday 8 weeks (as final dose) if 1st dose given at age 12−14mos No further doses needed if 1st dose given at age ≥15mos	4 weeks⁴ if current age is <12mos and 1st dose was given at <7mos of age, and at least 1 previous dose was PRP-T (ActHib, Pentacel, Hiberix), Vaxelis or unknown 8 weeks and age 12−59mos (as final dose)⁴ if current age is <12mos and 1st dose was given at age 7−11mos; OR if current age is 12−59mos and 1st dose was given before 1st birthday, and 2nd dose given at <15mos of age; OR if both doses were PRP-OMP (PedvaxHIB) and were given before 1st birthday No further doses needed if previous dose given at age ≥15mos	8 weeks (as final dose) This dose only necessary for ages 12−59mos who received 3 doses before 1st birthday
PCV⁵	6 weeks	4 weeks if 1st dose given before 1st birthday 8 weeks (as final dose for healthy children) if 1st dose given at or after 1st birthday No further doses needed for healthy children if 1st dose given at age ≥24mos	4 weeks if current age <12mos and previous dose given at age <7mos 8 weeks (as final dose for healthy children) previous dose given between 7−11mos (wait until at least 12mos old); OR if current age is ≥12mos and at least 1 dose was given before age 12mos. No further doses needed for healthy children if previous dose given at age ≥24mos	8 weeks (as final dose) This dose only necessary for ages 12−59mos regardless of risk, or ages 60−71mos with any risk, who received 3 doses before age 12mos
IPV⁶	6 weeks	4 weeks⁶	4 weeks⁶ if current age is <4yrs 6 months (as final dose) if current age is ≥4yrs	6 months⁶ minimum age 4yrs for final dose
MMR⁸	12 months	4 weeks
VAR⁹	12 months	3 months
HepA¹⁰	12 months	6 months
Meningococcal ACWY¹¹	2 months: Menveo; 2 years: MenQuadfi	8 weeks¹¹	see footnote 11	see footnote 11
Persons Aged 7−18 Years
Meningococcal ACWY¹¹	N/A	8 weeks¹¹
Td/Tdap¹²	7 years¹²	4 weeks	4 weeks if 1st dose of DTaP/DT given before 1st birthday 6 months (as final dose) if 1st dose of DTaP/DT or Tdap/Td given at or after 1st birthday	6 months if 1st dose of DTaP/DT given before 1st birthday
HPV¹³	9 years	Routine dosing intervals are recommended¹³
HepA¹⁰	N/A	6 months
HepB¹	N/A	4 weeks	8 weeks and at least 16wks after 1st dose
IPV⁶	N/A	4 weeks	6 months⁶ A 4th dose is not necessary if 3rd dose given at age ≥4yrs and ≥6mos after previous dose	A 4th dose is indicated if all previous doses were given at age <4yrs or if 3rd dose given <6mos after 2nd dose
MMR⁸	N/A	4 weeks
VAR⁹	N/A	3 months if person is <13yrs 4 weeks if person is ≥13yrs
Dengue¹⁴	9 years	6 months	6 months
Footnotes to 2024 CATCH-UP VACCINATION SCHEDULES: 4 MONTHS−18 YEARS OF AGE
The tables provide catch‑up schedules and minimum intervals between doses for children whose vaccinations have been delayed. A vaccine series does not need to be restarted, regardless of the time that has elapsed between doses. Use the section appropriate for the child’s age. Always use this table in conjunction with the child and adolescent immunization schedules (“Vaccination Schedule: 0−18 Years of Age”) and their respective footnotes. 1. Hepatitis B (HepB) vaccine. (Minimum age: birth)* • Unvaccinated persons should complete a 3-dose series at 0, 1–2, 6mos. • A 2‑dose series (doses separated by at least 4mos) of adult formulation Recombivax HB may be given to children aged 11−15yrs. • A 2-dose series at least 4wks apart of Heplisav-B, a 3-dose series at 0, 1, 6mos of PreHevbrio, or a 3- or 4-dose series of the combined HepA and HepB vaccine (Twinrix) may be given to adolescents aged ≥18yrs. 2. Rotavirus (RV) vaccines (Minimum age: 6wks for both RV1 [Rotarix] and RV5 [RotaTeq]) • Vaccination series should not be initiated on or after age 15wks, 0 days. The maximum age for final dose is 8mos, 0 days. • Administer a 2-dose series (Rotarix) or a 3-dose series (Rotateq). If any dose in the series is either Rotateq or unknown, default to a 3-dose series. 3. Diphtheria, tetanus, and acellular pertussis (DTaP) vaccine. (Minimum age: 6wks. Exception: DTaP‑IPV [Kinrix, Quadracel]: 4yrs) • The 5th dose of DTaP vaccine is not needed if 4th dose was given at age ≥4yrs and ≥6mos after 3rd dose. 4. Haemophilus influenzae type b (Hib) conjugate vaccine. (Minimum age: 6wks for PRP‑T [ActHIB, Hiberix], PRP‑OMP [PedvaxHIB], DTaP‑IPV/Hib [Pentacel], DTaP-IPV-Hib-HepB [Vaxelis]) • If the 1st dose was given at age 7−11mos, give the 2nd dose at least 4wks later and a 3rd (and final) dose at age 12−15mos or 8wks after 2nd dose, whichever is later. • If 1st dose was given at ages 12−14mos, give 2nd (final) dose at least 8wks after dose 1. • If 1st dose is given before 1st birthday and 2nd dose is given <15mos of age, a 3rd (and final) dose should be given at least 8wks after 2nd dose. • If 2 doses of PedvaxHIB were given before 1st birthday, the 3rd (and final) dose should be given at age 12−59mos and at least 8wks after the 2nd dose. • If 1 dose was given at age ≥15mos, no further doses needed. • For unvaccinated children aged 15–59mos, give only 1 dose. • Unvaccinated children age ≥60mos who are not considered high risk do not require catch-up vaccination. • Vaxelis can be used for catch-up vaccination in children age <5yrs. 5. Pneumococcal vaccines. (Minimum age: 6wks for PCV15 and PCV20, 2yrs for PPSV23) • Give 1 dose of PCV15 or PCV20 to healthy children ages 2–4yrs with any incomplete PCV series. • PCV20 is not indicated in healthy children if previously received 4 doses of PCV13 or PCV15 or another complete PCV series. 6. Inactivated poliovirus vaccine (IPV). (Minimum age: 6wks) • In the first 6mos of life, minimum age and minimum intervals are only recommended if the person is at risk for imminent exposure to circulating poliovirus (eg, travel to a polio-endemic region or during an outbreak). • If both trivalent OPV (tOPV) and IPV were given as part of a series, a total of 4 doses should be given to complete the series. Doses should be at least 4wks apart, with the final dose given on or after the 4th birthday and at least 6mos after the previous dose. If only OPV were given, and all doses given before 4yrs of age, 1 dose of IPV should be given at age ≥4yrs, at least 6mos after last OPV dose. • Only tOPV counts toward the US vaccination requirements. Doses of OPV given before 4/1/2016 should be counted (unless noted as given during a campaign). Doses of OPV given on or after 4/1/2016 should not be counted. • Unvaccinated or incompletely vaccinated adolescents age 18yrs should receive remaining IPV doses to complete a 3-dose primary series. Those who completed the primary series and remains at risk may receive one lifetime IPV booster. 7. Influenza vaccines. (Minimum age: 6mos for inactivated influenza vaccine [IIV], 2yrs for live attenuated influenza vaccine [LAIV4], 18yrs for recombinant influenza vaccine [RIV4]) • Use any age and health status-appropriate influenza vaccine annually. • See “VACCINATION SCHEDULE: 0−18 YEARS OF AGE” for further guidance. 8. Measles, mumps, and rubella (MMR) vaccine. (Minimum age: 12mos for routine vaccination) • Unvaccinated persons should complete a 2-dose series at least 4wks apart. • Maximum age for MMRV vaccine: 12yrs. • Minimum interval between MMRV doses: 3mos 9. Varicella (VAR) vaccine. (Minimum age: 12mos) • Ensure that all persons aged 7−18yrs without evidence of immunity have 2 doses of varicella vaccine. For children aged 7−12yrs, the recommended interval between doses is 3mos (if the 2nd dose was given at least 4wks after the 1st dose, it can be accepted as valid); for persons aged ≥13yrs, the routine interval between doses is 4–8wks. • Maximum age for MMRV vaccine: 12yrs. 10. Hepatitis A vaccine (HepA). (Minimum age: 12mos) • Unvaccinated children through 18yrs should complete 2 doses ≥6mos apart. • Children who previously received 1 dose at age ≥12mos should receive 2nd dose ≥6mos after 1st dose. • Adolescents aged ≥18yrs may receive a 3- or 4-dose series of the combined HepA and HepB vaccine (Twinrix). 11. Meningococcal vaccines. (Minimum age: 2mos for MenACWY-CRM [Menveo], 2yrs for MenACWY-TT [MenQuadfi], 10yrs for serogroup B meningococcal [MenB] vaccines: MenB-4C [Bexsero] and MenB-FHbp [Trumenba], 10yrs for MenACWY-TT/MenB-FHbp [Penbraya]) • MenACWY vaccines: − Age 13-15yrs: give 1 dose and a booster at age 16-18yrs (≥8wks between doses). − Age 16-18yrs: give 1 dose − If not previously vaccinated at 16yrs, give 1 dose to 1st-year college students living in residential housing or military recruits. • MenB vaccines: − a 2-dose series may be given based on shared clinical decision-making to persons 16−23yrs (16−18 preferred) who are not at increased risk. − Bexsero and Trumenba are not interchangeable; use the same product for all doses in a series. • MenACWY and MenB vaccines may be given simultaneously but at different anatomic sites, if feasible. • Children age ≥10yrs may receive 1 dose of Penbraya as an alternative to separate administration of MenACWY and MenB when both vaccines would be given on the same clinic day. − Children not at increased risk: if Penbraya is used for 1st dose of MenB, Trumenba should be given for 2nd dose. − Children at increased risk: Penbraya may be used for additional MenACWY and MenB doses (including booster). The interval between Penbraya doses is ≥6mos. 12. Tetanus, diphtheria, and acellular pertussis (Tdap) vaccine. (Minimum age: 11yrs for routine vaccination, 7yrs for catch-up) • Persons 13−18yrs who have not received Tdap vaccine should receive 1 dose of Tdap (adolescent booster). • Persons 7−18yrs not fully immunized with DTaP should receive 1 dose of Tdap as part of the catch-up series (preferably 1st dose). Give Td or Tdap if more doses are needed. • Children age 7−9yrs who receive Tdap should receive the adolescent Tdap booster dose at age 11–12yrs. Children age 10yrs who receive Tdap do not need the adolescent Tdap booster dose at age 11–12yrs. • Inadvertent doses of DTaP vaccine: − If administered inadvertently at age 7–9yrs, DTaP may count as part of the catch‑up series. The adolescent Tdap booster should be given at age 11–12yrs. − If administered inadvertently at age 10−18yrs, the dose should be counted as the adolescent Tdap booster. 13. Human papillomavirus (HPV) vaccines. (Minimum age: 9yrs for 9vHPV [Gardasil 9]) • Give HPV vaccine to all adolescents age 11–12yrs (can start at 9yrs) and through age 18yrs if not adequately vaccinated. • Give 2 doses at 0, 6−12mos if initiating vaccination at age 9−14yrs. Minimum interval between doses is 5mos; repeat dose if given too soon. • Give 3 doses at 0, 1−2, 6mos if initiating vaccination at age ≥15yrs. Minimum intervals are 4wks between 1st and 2nd dose, 12wks between 2nd and 3rd dose; and 5mos between 1st and 3rd dose; repeat dose if given too soon. • Series does not need to be restarted if vaccination schedule is interrupted. • No additional doses needed if valid vaccination series completed with any HPV vaccine. 14. Dengue vaccine (Minimum age: 9yrs for DEN4CYD [Dengvaxia]) • Give 3 doses at 0, 6, 12mos in persons age 9−16yrs who live in dengue endemic areas and have laboratory-confirmed previous dengue infection • Children traveling to or visiting dengue endemic areas should not be vaccinated. 15. Covid-19 vaccines (Minimum age: 6mos for Moderna and Pfizer-BioNTech vaccines; 12yrs for Novavax vaccine) • ACIP recommends use of COVID-19 vaccines for everyone ages ≥6mos. • Unvaccinated children and those previously vaccinated with any Original monovalent or bivalent COVID-19 vaccine (Janssen, Moderna, Novavax, Pfizer-BioNTech) should receive age-appropriate doses of the updated 2023-2024 formulation (no preferential recommendation for the use of any one vaccine over another). • The Novavax vaccine remains authorized for use as a 2-dose primary series in children age ≥12yrs. • The Original monovalent and bivalent (Original and Omicron BA.4/BA.5) formulations should no longer be used for vaccination. The Janssen vaccine is no longer available in the US. • For a list of currently available COVID-19 vaccines and other recommendations for COVID-19 vaccination including dosing for immunocompromised adults, see https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html. 16. Respiratory syncytial virus (RSV vaccine, RSV-mAb). (Minimum age: birth for nirsevimab [Beyfortus]) • Either maternal RSV vaccination with Abrysvo or infant immunization with nirsevimab is recommended to prevent RSV lower respiratory tract infection in infants. • Infants: give 1 dose of nirsevimab; timing of administration is dependent on birth month (RSV seasonality) and mother’s RSV vaccination status. Nirsevimab can be given to children who are eligible to receive palivizumab. If previously received nirsevimab, palivizumab should not be given for the same RSV season. • Pregnant persons: give 1 dose of RSV vaccine Abrysvo at 32wks 0 days through 36wks 6 days gestation from September through January, regardless of previous RSV infection. There is currently no recommendation for RSV vaccination in subsequent pregnancies. • See “VACCINATION SCHEDULE: 0−18 YEARS OF AGE” for further guidance 17. Mpox vaccine. (Minimum age: 18yrs for Jynneos) • Give a 2-dose series, 28 days apart, to persons age 18yrs and at risk for mpox infection NOTE: Refer to the ACIP 2024 Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger footnotes for vaccinations of persons with high risk conditions or other special situations.
CHANGES IN THE SCHEDULE SINCE LAST RELEASE
• The 20-valent pneumococcal conjugate vaccine (PCV20), Mpox vaccine (Jynneos), RSV monoclonal antibody (nirsevimab), RSV vaccine (Abrysvo), and MenACWY-TT/MenB-FHbp vaccine (Penbraya) has been added to the vaccination schedule. • PCV13 has been removed from the schedule and the pneumococcal footnote has been updated with the new recommendations for PCV15, PCV20, and PPSV23. • The polio footnote has been revised to include updated recommendations for adolescents age 18yrs. • The meningococcal vaccines footnote has been updated to remove Menactra and include recommendation for the use of the new meningococcal A, B, C, W, Y vaccine (Penbraya). • The Tdap footnote has been revised to clarify the adolescent booster dose at age 11-12yrs. • The COVID-19 footnote has been revised to include the updated Covid-19 vaccines 2023-2024 formulation. • An RSV immunization footnote has been added to provide guidance on the use of nirsevimab in infants and RSV vaccine (Abrysvo) during pregnancy. • An Mpox vaccine footnote has been added to provide guidance for the use of Jynneos.
REFERENCES
For information on individual vaccines see product monographs, contact the manufacturer, or call the National Immunization Hotline at (800) 232-4636. Advisory Committee on Immunization Practices (ACIP). Recommended Catch-up Immunization Schedule for Children and Adolescents Who Start Late or Who Are More than 1 Month Behind, United States, 2024. Accessed January 23, 2024. https://www.cdc.gov/vaccines/schedules/hcp/imz/catchup.html. Centers for Disease Control and Prevention. Interim Clinical Considerations for Use of COVID-19 Vaccines in the United States. Updated January 18, 2024. Accessed January 24, 2024. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html. (Rev. 2/2024)

2024 Vaccination Schedule: 0-18 Years of Age

Haymarket Media — Mon, 07 Apr 2014 21:00:00 +0000

2024 Vaccination Schedule: 0-18 Years of Age

2024 VACCINATION SCHEDULE: 0–18 YEARS OF AGE
Any dose not administered at the recommended age should be administered at a subsequent visit, when indicated and feasible. The use of a combination vaccine generally is preferred over separate injections of its equivalent component vaccines. Considerations should include provider asessment, patient preference, and the potential for adverse events. Consult full product labeling for detailed recommendations.
Range of recommended ages for all children			Range of recommended ages for catch-up immunization			Range of recommended ages for certain high-risk groups				Recommended immunization can begin in this age group			Recommended vaccination based on shared clinical decision-making

Vaccine	Birth	1 mo	2 mos	4 mos	6 mos	9 mos	12 mos	15 mos	18 mos	19–23 mos	2–3 yrs	4–6 yrs	7–10 yrs			11–12 yrs	13–15 yrs	16 yrs	17–18 yrs
Vaccine	Respiratory syncytial virus ¹⁶ (RSV-mAb)	1 dose depending on maternal RSV vaccine status see footnote 16				1 dose (8–19mos) see footnote 16
Hepatitis B¹ (HepB)	1^st dose	2^nd dose			3^rd dose
Rotavirus² (RV) RV1 (2-dose series); RV5 (3-dose series)			1^st dose	2^nd dose	see footnote 2
Diphtheria, tetanus, & acellular pertussis³ (DTaP: <7yrs)			1^st dose	2^nd dose	3^rd dose			4^th dose				5^th dose
Haemophilus influenzae type b⁴ (Hib)			1^st dose	2^nd dose	see footnote 4		3^rd or 4^th dose see footnote 4
Pneumococcal conjugate⁵ (PCV15, PCV20)			1^st dose	2^nd dose	3^rd dose		4^th dose
Inactivated poliovirus⁶ (IPV:<18yrs)			1^st dose	2^nd dose	3^rd dose							4^th dose								see foot- note 6
COVID-19¹⁵ (1vCOV-mRNA, 1vCOV-aPS)					1 or more doses of updated 2023–2024 formulation See footnote 15
Influenza⁷ (IIV4) OR					Annual vaccination 1 or 2 doses									Annual vaccination 1 dose only
Influenza⁷ (LAIV4)											Annual vaccination 1 or 2 doses			Annual vaccination 1 dose only
Measles, mumps, rubella⁸ (MMR)					see footnote 8		1^st dose					2^nd dose
Varicella⁹ (VAR)							1^st dose					2^nd dose
Hepatitis A¹⁰ (HepA)					see footnote 10		2 dose series see footnote 10
Tetanus, diphtheria, & acellular pertussis¹² (Tdap: ≥7yrs)																1 dose
Tetanus, diphtheria, & acellular pertussis¹² (Tdap: ≥7yrs)																1 dose
Human papillomavirus¹³ (HPV)																see footnote 13
Human papillomavirus¹³ (HPV)																see footnote 13
Meningococcal¹¹ (MenACWY-CRM ≥2mos; MenACWY-TT ≥2yrs)			see footnote 11													1^st dose		2nd dose
Meningococcal B¹¹ (MenB-4C, MenB-FHbp)														see footnote 11
Meningococcal B¹¹ (MenB-4C, MenB-FHbp)
Respiratory syncytial virus¹⁶ (RSV vaccine)																Seasonal during pregnancy see footnote 16
Dengue¹⁴ (DEN4CYD: 9-16yrs)															Seropositive in endemic areas only: see footnote 14
Mpox¹⁷

1. Hepatitis B (HepB) vaccine. (Min age: birth) At birth: • HBsAg-negative mother: administer 1 dose of monovalent HepB vaccine within 24hrs of birth for all medically stable infants ≥2000g. For infants <2000g, give 1 dose at chronological age 1 month or hospital discharge (whichever is earlier even if weight remains <2000g). • HBsAg-positive mother: administer 1 dose of monovalent HepB vaccine and hepatitis B immune globulin (HBIG) within 12hrs of birth, regardless of birth weight. For infants <2000g, administer 3 more doses of vaccine (4 total) beginning at age 1 month. Test for HBsAg and antibody to HBsAg (anti-HBs) at age 9–12mos or 1–2mos after final dose if the series was delayed. • Unknown HBsAg status: administer monovalent HepB vaccine within 12hrs of birth, regardless of birth weight. For infants <2000g, add HBIG within 12hrs of birth, and 3 more doses of vaccine (4 total) beginning at age 1 month. For infants weighing ≥2000g, determine mother’s HBsAg status as soon as possible and, if she is HBsAg-positive, also give HBIG as soon as possible but no later than age 1wk. If HBsAg-positive or status remains unknown, test for HBsAg and anti-HBs at age 9–12mos or 1–2mos after final dose if the series was delayed. Doses after the birth dose: • The 2nd dose should be administered at age 1–2mos and the 3rd dose at 6–18mos. Monovalent HepB vaccine should be used for doses administered before age 6wks. • Infants who did not receive a birth dose should receive 3 doses of a HepB-containing vaccine as soon as feasible. • The minimum interval is 4wks for the 1st and 2nd dose, 8wks for the 2nd and 3rd dose, and 16wks for the 1st and 3rd dose (if 4 doses, substitute 4th dose for 3rd dose in these calculations). The final (3rd or 4th) dose in the HepB vaccine series should be administered no earlier than age 24wks. • Administration of a total of 4 doses of HepB vaccine is permitted when a combination vaccine containing HepB is administered after the birth dose. • Revaccination may be recommended for: infants born to HBsAg-positive mothers, hemodialysis patients, or other immunocompromised persons. • For catch-up vaccination recommendations, refer to the 2024 Catch-Up Vaccination Schedule: 4 Months–18 years chart. 2. Rotavirus (RV) vaccine. (Min age: 6wks for both RV1 [Rotarix] and RV5 [RotaTeq]) • Administer a series of RV vaccine to all infants as follows: 1. If Rotarix is used, administer a 2-dose series at 2 and 4mos of age. 2. If RotaTeq is used, administer a 3-dose series at ages 2, 4, and 6mos. 3. If any dose in the series is either RotaTeq or unknown, default to 3-dose series. 3. Diphtheria, tetanus, and acellular pertussis (DTaP) vaccine. (Min age: 6wks. Exception: DTaP-IPV [Kinrix, Quadracel]: 4yrs) • Administer a 5-dose series of DTaP vaccine at ages 2, 4, 6, 15−18mos, and 4−6yrs. The 4th dose may be administered as early as age 12mos, provided at least 6mos have elapsed since the 3rd dose. If the 4th dose was inadvertently given as early as 12mos, it may be counted if given ≥4mos after the 3rd dose. • 5th dose of DTaP vaccine is not needed if 4th dose was given at age ≥4yrs and ≥6mos after 3rd dose. • For wound management in children age <7yrs with ≥3 doses of tetanus-toxoid-containing vaccine, administer DTaP for all wounds except clean and minor wounds if >5yrs since last dose of tetanus-toxoid-containing vaccine. *4. Haemophilus influenzae* type b (Hib) conjugate vaccine.** (Minimum age: 6wks for PRP‑T [ActHIB, Hiberix], PRP‑OMP [PedvaxHIB], DTaP‑IPV/Hib [Pentacel], DTaP-IPV-Hib-HepB [Vaxelis]) • Administer a 4-dose Hib vaccine series at 2, 4, and 6mos, then a booster dose at 12−15mos for ActHIB, Hiberix, Pentacel, or Vaxelis. Do not use Vaxelis as a booster dose; use a different Hib-containing vaccine. For PedvaxHIB, administer a 3-dose series at 2 and 4mos, then a booster dose at 12−15mos. • For catch-up vaccination recommendations, refer to the 2024 Catch-Up Vaccination Schedule: 4 Months−18 years chart. • Persons with high-risk conditions: refer to the ACIP 2024 Immunization Schedule footnotes. 5. Pneumococcal vaccines. (Min age: 6wks for PCV15 and PCV20, 2yrs for PPSV23) Routine vaccination with PCV: • Administer a 4-dose series of PCV vaccine at ages 2, 4, 6mos and at age 12−15mos. • Either PCV15 or PCV20 can be used for PCV vaccination. PCV20 is not indicated in healthy children if previously received 4 doses of PCV13 or PCV15 or another complete PCV series. • Persons with high-risk conditions: refer to the ACIP 2024 Immunization Schedule footnotes. 6. Inactivated poliovirus vaccine (IPV). (Min age: 6wks) • Administer a 4-dose series of IPV at ages 2, 4, 6−18mos and 4−6yrs. The final dose in the series should be administered on or after the 4th birthday and at least 6mos after the previous dose. • If ≥4 doses of IPV-containing combination vaccine are given before age 4yrs, an additional dose should be given on or after the 4th birthday and ≥6mos after the previous dose. • If both trivalent OPV (tOPV) and IPV were given as part of a series, a total of 4 doses should be given to complete the series. Doses should be at least 4wks apart, with the final dose given on or after the 4th birthday and at least 6mos after the previous dose. If only OPV were given, and all doses given before 4yrs of age, 1 dose of IPV should be given at age ≥4yrs, at least 6mos after last OPV dose. • Only tOPV counts toward the US vaccination requirements. Doses of OPV given before 4/1/2016 should be counted (unless noted as given during a campaign). Doses of OPV given on or after 4/1/2016 should not be counted. • Unvaccinated or incompletely vaccinated adolescents age 18yrs should receive remaining IPV doses to complete a 3-dose primary series. Those who completed the primary series and remains at risk may receive one lifetime IPV booster. 7. Influenza vaccines. (Min age: 6mos for inactivated influenza vaccine [IIV4], 2yrs for live attenuated influenza vaccine [LAIV4], 18yrs for recombinant influenza vaccine [RIV4]) • For the 2023–2024 season, administer 2 doses at least 4wks apart to children 6mos–8yrs who have not previously received ≥2 doses of influenza vaccine before July 1, 2023, or whose influenza vaccination history is unknown. Administer 1 dose if previously received ≥2 doses before July 1, 2023. • Administer 1 dose for all children age ≥9yrs. • Children with allergy to eggs can receive any influenza vaccine (egg-based and non-egg-based) appropriate for age and health status. • Contraindications and precautions for influenza vaccines: refer to the ACIP 2024 Immunization Schedule footnotes or the product labeling. 8. Measles, mumps, and rubella (MMR) vaccine. (Min age: 12mos) • Administer a 2-dose series of MMR vaccine at ages 12−15mos and 4−6yrs. • MMR (doses ≥4wks apart) or MMRV (doses ≥3mos apart) may be administered. For the 1st dose in ages 12–47mos, a separate MMR and varicella vaccine is recommended, unless MMRV preferred. The maximum age for MMRV is 12yrs. • Administer 1 dose of MMR to infants aged 6−11mos before departure from the U.S. for international travel. These children should be revaccinated with 2 doses, the 1st at age 12−15mos (12mos for children in high-risk areas), and the 2nd dose at least 4wks later. Unvaccinated children ≥12mos should receive 2 doses at least 4 wks apart before departure. 9. Varicella (VAR) vaccine. (Min age: 12mos) • Administer a 2-dose series of VAR vaccine at ages 12−15mos and 4−6yrs. The 2nd dose may be administered as early as 3mos after the 1st dose. If the 2nd dose was given at least 4wks after the 1st dose, it can be accepted as valid. • VAR or MMRV may be administered. For the 1st dose in ages 12–47mos, a separate MMR and varicella vaccine is recommended, unless MMRV preferred. The maximum age for MMRV is 12yrs. 10. Hepatitis A (HepA) vaccine. (Min age: 12mos) • Initiate the 2-dose HepA vaccine series, separated by ≥6mos beginning at age 12–23mos. • Administer 1 dose of HepA vaccine to infants aged 6–11mos before departure to countries with high or intermediate HepA endemicity; revaccinate with 2 doses, ≥6mos apart, between age 12–23mos. Unvaccinated children aged ≥12mos should receive 1 dose as soon as travel is considered. • For catch-up vaccination recommendations, refer to the 2024 Catch-Up Vaccination Schedule: 4 Months–18 years chart. 11. Meningococcal vaccines. (Min age: 2mos for MenACWY-CRM [Menveo], 2yrs for MenACWY-TT [MenQuadfi], 10yrs for serogroup B meningococcal [MenB] vaccines: MenB-4C [Bexsero] and MenB-FHbp [Trumenba], 10yrs for MenACWY-TT/MenB-FHbp [Penbraya]) • MenACWY vaccination (Menveo, MenQuadfi): — Administer a 2-dose series at 11−12yrs and 16yrs. — Administer 1 dose to 1st-year college students living in residential housing (if not previously vaccinated at ≥16yrs) or military recruits. — Children who received MenACWY before age 10yrs and for whom boosters are recommended due to ongoing increased meningococcal risk should follow the booster schedule for persons at increased risk. If boosters are not recommended, administer routine vaccination at 11−12yrs and 16yrs. — Menveo is available in 2 formulations (lyophilized and liquid). The liquid formulation should not be used before age 10yrs. • MenB vaccination (Bexsero, Trumenba): — Persons 16−23yrs (16−18yrs preferred) not at increased risk may receive, based on shared clinical decision-making, 2 doses of Bexsero at least 1 month apart or 2 doses of Trumenba at least 6mos apart (if 2nd Trumenba dose given too soon, administer a 3rd dose at least 4mos after the 2nd dose). — Bexsero and Trumenba are not interchangeable; use the same product for all doses in a series. • MenACWY and MenB vaccines may be given simultaneously but at different anatomic sites, if feasible. • Children age ≥10yrs may receive 1 dose of Penbraya as an alternative to separate administration of MenACWY and MenB when both vaccines would be given on the same clinic day. — Children not at increased risk: if Penbraya is used for 1st dose of MenB, Trumenba should be given for 2nd dose. — Children at increased risk: Penbraya may be used for additional MenACWY and MenB doses (including booster). The interval between Penbraya doses is ≥6mos. • Persons with high-risk conditions or those traveling to or living in countries where meningococcal disease is hyperendemic or epidemic: refer to the ACIP 2024 Immunization Schedule footnotes. • Additional information on MenACWY and MenB booster doses in special situations is available at https://www.cdc.gov/mmwr/volumes/69/rr/rr6909a1.htm. 12. Tetanus, diphtheria, and acellular pertussis (Tdap) vaccine. (Min age: 11yrs for routine vaccination, 7yrs for catch-up) • Give 1 dose of Tdap (adolescent booster) at age 11–12yrs. • Tdap can be administered regardless of the interval since the last tetanus and diphtheria toxoid-containing vaccine. • Administer 1 dose of Tdap vaccine to pregnant adolescents during each pregnancy (preferably during the early part of gestational weeks 27–36). • For catch-up vaccination recommendations, refer to the 2024 Catch-Up Vaccination Schedule: 4 Months−18 years chart. • For wound management in children age ≥7yrs with ≥3 doses of tetanus-toxoid-containing vaccine, administer Tdap or Td for clean and minor wounds if >10yrs since last dose of tetanus-toxoid-containing vaccine. For all other wounds, administer Tdap or Td if >5yrs since last dose of tetanus vaccine. Tdap is preferred for age ≥11yrs with no or unknown history of Tdap vaccination, or in pregnancy. 13. Human papillomavirus (HPV) vaccines. (Min age: 9yrs for 9vHPV [Gardasil 9]) • Adolescents age 11−12yrs (can start at age 9yrs) and through 18yrs (if not previously adequately vaccinated) should receive HPV vaccine series. Number of doses is dependent on age at initial vaccination: — Initiated at age 9−14yrs: administer a 2-dose series at 0, 6–12mos. The minimum interval between doses is 5mos; repeat dose if given too soon. — Initiated at age ≥15yrs: administer a 3-dose series at 0, 1−2, and 6mos. The 1st and 2nd dose should be at least 4wks apart, the 2nd and 3rd dose at least 12wks apart, and the 1st and 3rd dose at least 5mos apart; repeat dose if given too soon. • No additional doses are needed for persons who have completed a valid series with any HPV vaccine. • Administer HPV vaccine beginning at age 9yrs to children with any history of sexual abuse or assault. • Immunocompromised children should receive a 3-dose series at 0, 1−2, and 6mos, regardless of age at vaccine initiation. • HPV vaccination is not recommended for pregnancy. However, pregnancy testing is not needed before vaccination. If found to be pregnant after initiating the vaccination series, no intervention is needed; the remainder of the series should be delayed until completion of pregnancy. 14. Dengue vaccine (Min age: 9yrs for DEN4CYD [Dengvaxia]) • Give 3 doses at 0, 6, 12mos in persons age 9−16yrs who live in dengue endemic areas and have laboratory-confirmed previous dengue infection. • Children traveling to or visiting dengue endemic areas should not be vaccinated. 15. Covid-19 vaccines (Min age: 6mos for Moderna and Pfizer-BioNTech vaccines; 12yrs for Novavax vaccine) • ACIP recommends use of COVID-19 vaccines for everyone ages ≥6mos. • Unvaccinated children and those previously vaccinated with any Original monovalent or bivalent COVID-19 vaccine (Janssen, Moderna, Novavax, Pfizer-BioNTech) should receive age-appropriate doses of the updated 2023-2024 formulation (no preferential recommendation for the use of any one vaccine over another). • The Novavax vaccine remains authorized for use as a 2-dose primary series in children age ≥12yrs. • The Original monovalent and bivalent (Original and Omicron BA.4/BA.5) formulations should no longer be used for vaccination. The Janssen vaccine is no longer available in the US. • For a list of currently available COVID-19 vaccines and other recommendations for COVID-19 vaccination including dosing for immunocompromised adults, see https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html. 16. Respiratory syncytial virus (RSV vaccine, RSV-mAb). (Min age: birth for nirsevimab [Beyfortus]) • Either maternal RSV vaccination with Abrysvo or infant immunization with nirsevimab is recommended to prevent RSV lower respiratory tract infection in infants. • Infants: give 1 dose of nirsevimab; timing of administration is dependent on birth month (RSV seasonality) and mother’s RSV vaccination status. Nirsevimab can be given to children who are eligible to receive palivizumab. If previously received nirsevimab, palivizumab should not be given for the same RSV season. • Pregnant persons: give 1 dose of RSV vaccine Abrysvo at 32wks 0 days through 36wks 6 days gestation from September through January, regardless of previous RSV infection. There is currently no recommendation for RSV vaccination in subsequent pregnancies. 17. Mpox vaccine (Min age: 18yrs for Jynneos) • Give a 2-dose series, 28 days apart, to persons age 18yrs and at risk for mpox infection.
*NOTE: Refer to the ACIP 2024 Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger* footnotes for vaccinations of persons with high risk conditions.**
CHANGES IN THE SCHEDULE SINCE LAST RELEASE
• The 20-valent pneumococcal conjugate vaccine (PCV20), Mpox vaccine (Jynneos), RSV monoclonal antibody (nirsevimab), RSV vaccine (Abrysvo), and MenACWY-TT/MenB-FHbp vaccine (Penbraya) has been added to the vaccination schedule. • PCV13 has been removed from the schedule and the pneumococcal footnote has been updated with the new recommendations for PCV15, PCV20, and PPSV23. • The polio footnote has been revised to include updated recommendations for adolescents age 18yrs at increased risk for exposure. • The influenza footnote has been updated for the 2023-2024 season and clarifications were added for children with history of egg allergy. • The meningococcal vaccines footnote has been updated to remove Menactra and include recommendations for the use of the new meningococcal A, B, C, W, Y vaccine (Penbraya). • The Tdap footnote has been revised to clarify the adolescent booster dose at age 11-12yrs. • The COVID-19 footnote has been revised to include the updated Covid-19 vaccines 2023-2024 formulation. • An RSV immunization footnote has been added to provide guidance on the use of nirsevimab in infants and RSV vaccine (Abrysvo) during pregnancy. • An Mpox vaccine footnote has been added to provide guidance for the use of Jynneos.
REFERENCES
For information on individual vaccines, please see product monographs at www.eMPR.com, contact company for full labeling, or call the National Immunization Hotline at (800) 232-4636. Source: Advisory Committee on Immunization Practices (ACIP). Child and Adolescent Immunization Schedule by Age: Recommendations for Ages 18 Years or Younger, United States, 2024. Accessed January 23, 2024. https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html. Centers for Disease Control and Prevention. Interim Clinical Considerations for Use of COVID-19 Vaccines in the United States. Updated January 18, 2024. Accessed January 24, 2024. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html. (Rev. 2/2024)

4-Antigen Staphylococcus aureus Vaccine Did Not Prevent Infection During Surgery

Steve Duffy — Fri, 30 Jun 2023 13:00:00 +0000

The investigational 4-antigen Staphylococcus aureus vaccine (SA4Ag) did not protect adults against Staphylococcus aureus infection during elective spinal fusion surgery, according to a new report published in Clinical Infectious Diseases.

Exposure to S aureus in hospital settings, especially during orthopedic surgeries, leaves patients at risk for surgical site infections (SSIs) and other complications. Prophylactic antibiotic administration can be effective but does not protect against antibiotic-resistant S aureus that causes most of these infections. Vaccines to protect against S aureus represent a potential solution. However, this strategy has not been successful in human trials. Therefore, the researchers aimed to develop a new vaccine, SA4Ag, that targets 4 virulence factors that are required for S aureus survival.

The Staphylococcus aureus suRgical Inpatient Vaccine Efficacy (STRIVE) study was a phase 2b, randomized, placebo-controlled, double-blind trial that enrolled participants in North America, Europe, and Japan. Participants who were aged 18 to 85 years and scheduled for single or multilevel spinal fusion surgery were enrolled. Surgical procedures involved multilevel instrumentation in all participants.

Of the 3450 patients enrolled, 3193 (92.6%) completed the study. Participants were randomly assigned to receive a single dose of SA4Ag or placebo. The primary objective was preventing S aureus SSIs within 90 days of surgery, and infections 90 to 180 days after surgery represented secondary efficacy and exploratory outcomes. Twenty-four S aureus cases at the interim point or 48 cases at the endpoint were required to meet futility criteria.

Enrollment in the study was halted after predefined futility criteria were met at the interim point (conditional power 6.09%). Vaccine efficacy (VE) for all types of infection was 0.0% (95% confidence interval [CI], -126.3% to 55.8%) within 90 days of surgery. VE for blood infections alone was 36.4% (95% CI, -79.8% to 79.1%), and most participants with blood infections also presented with surgical site infections (85.7%). The infection rate among participants who received a placebo was 0.9%. Efficacy was not improved between 90 and 180 days after surgery in the participants who received SA4Ag.

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“Despite these findings, efforts to develop a safe and effective vaccine to lower the substantial global burden of S aureus infections should remain a priority.”

Immunogenicity against 2 of the antigens targeted by SA4Ag (capsular polysaccharide conjugates of serotypes 5 and 8) was increased in patients who received the vaccine regardless of whether S aureus infection was present. Antibody levels were sustained at 90 days post-vaccination. No serious adverse events were reported during the study, and urinary tract infections were the only adverse event that occurred at a rate higher than 1%.

Because the study was halted after interim analysis when enrollment was incomplete, the relatively low number of participants precluded subgroup efficacy. The variability in surgical procedures among participants and lower than expected infection rate in the placebo group could also represent a limitation in the interpretation of the data.

This large prospective study reported that a new vaccine that targets critical virulence components in S aureus among patients who underwent spinal fusion surgery was safe and well-tolerated. Antibodies against targeted antigens increased. However, efficacy was not observed. The researchers reported, “Despite these findings, efforts to develop a safe and effective vaccine to lower the substantial global burden of S aureus infections should remain a priority.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. This research was supported by Pfizer. Please see the original reference for a full list of disclosures.

4CMenB Vaccination Effective Against Invasive Meningococcal Disease in Children Under 5

Haymarket Media — Fri, 03 Feb 2023 14:00:00 +0000

HealthDay News — Complete vaccination with the 4-component, protein-based meningococcal serogroup B vaccine (4CMenB) is effective for preventing invasive meningococcal disease in children younger than 5 years, according to a study published in the February 2 issue of the New England Journal of Medicine.

Jesús Castilla, MD, PhD, from the Instituto de Salud Pública de Navarra in Pamplona, Spain, and colleagues examined the effectiveness of 4CMenB in preventing invasive meningococcal disease in children in a nationwide matched case-control study. All laboratory-confirmed cases of invasive meningococcal disease in children younger than 60 months between October 5, 2015, and October 6, 2019, were identified; 306 cases (79.4% with serogroup B disease) were matched to 1224 controls.

The researchers found that 11.4 and 24.3% of case patients and controls, respectively, had received at least one dose of 4CMenB. The effectiveness against invasive meningococcal disease caused by any serogroup was 76% for complete vaccination (receipt of at least 2 doses) and 54% for partial vaccination. The effectiveness against meningococcal serogroup B disease was 71% for complete vaccination. Vaccine effectiveness with at least one dose of 4CMenB was 64 and 82% against serogroup B disease and non-serogroup B disease, respectively. Forty-four case patients had serogroup B strains that were expected to be covered by 4CMenB; none of these patients had been vaccinated.

“This evidence may be useful in making decisions about the inclusion of this vaccine in the immunization program of countries where invasive meningococcal disease in children is problematic and its prevention a priority,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

AACR: mRNA-4157 Plus Pembrolizumab Beneficial in Melanoma

Haymarket Media — Tue, 18 Apr 2023 13:00:00 +0000

HealthDay News — For patients with completely resected, high-risk cutaneous melanoma, the novel mRNA-based cancer vaccine (mRNA-4157) combined with pembrolizumab results in improved recurrence-free survival (RFS) compared with pembrolizumab alone, according to a study presented at the annual meeting of the American Association for Cancer Research, held from April 14 to 19 in Orlando, Florida.

Adnan Khattak, MBBS, from Hollywood Private Hospital in Nedlands, Australia, and colleagues randomly assigned eligible patients with completely resected, high-risk cutaneous melanoma to receive mRNA-4157 in combination with pembrolizumab or pembrolizumab alone (107 and 50 patients, respectively).

The researchers found that recurrence or death was reported in 22.4 and 40% of patients in the combination and monotherapy arms, respectively, at a median follow-up of 101 and 105 weeks. In the combination and monotherapy arms, the 18-month RFS rates were 78.6 and 62.2%, respectively. Protocol-defined statistical significance and clinically meaningful improvement in RFS was seen with the combination versus pembrolizumab, with a 44% reduction noted in the risk for recurrence or death. The number of patients reporting treatment-related grade 3 or higher adverse events was similar between the arms (25 and 18% for combination and monotherapy, respectively); fatigue was the most common mRNA-4157-related grade 3 event.

“Our phase 2b study shows that a neoantigen mRNA vaccine, when used in combination with pembrolizumab, resulted in prolonged time without recurrence or death compared with pembrolizumab alone,” a coauthor said in a statement.

Several authors disclosed financial ties to pharmaceutical companies, including Moderna and Merck, which are jointly developing and commercializing mRNA-4157/V940.

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AACR: Novel Personalized Vaccine Feasible for Head and Neck Cancer

Haymarket Media — Wed, 10 Apr 2024 13:00:00 +0000

HealthDay News — The novel viral-based personalized cancer vaccine, TG4050, which encodes up to 30 patient- and tumor-specific sequences is feasible and safe for patients with resected head and neck squamous cell carcinoma, according to a study presented at the annual meeting of the American Association for Cancer Research, held from April 5 to 10 in San Diego.

Ana I. Lalanne, PhD, from the Institut Curie in Paris, and colleagues randomly assigned eligible patients with completely resected stage III or IV human papillomavirus-negative squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx to receive TG4050 immediately (arm A; 17 patients) or upon relapse (arm B; 16 patients) after completion of standard-of-care adjuvant radio-chemotherapy.

The researchers found that TG4050 adverse events were mild to moderate, and most of them were injection site reactions. No relapse occurred in arm A, and 3 patients relapsed in arm B after 6.2, 8.8, and 18.5 months, after a median follow-up of 16.2 months. T-cell responses were de novo or amplification of preexisting responses (82 and 18 percent, respectively). There was a median of 6 vaccine responses observed. An effector memory phenotype was indicated in cytometric characterization of vaccine-specific T-cells. In 5 patients, T-cell receptor sequencing of blood T-cells evidenced expansion of tumor-infiltrating lymphocyte clonotypes. In the blood of 2 patients, the most expanded vaccine-specific CD8 T-cells represented oligoclonal expansions expressing an effector phenotype.

“Our findings indicate that TG4050 is safe and promotes an immune response against several neoantigens in most patients,” coauthor Olivier Lantz, MD, PhD, also from the Institute Curie, said in a statement.

Several authors disclosed ties to pharmaceutical companies, including Transgene, which sponsored the study and jointly funded it with NEC.

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ABRYSVO

Haymarket Media — Fri, 27 Oct 2023 18:53:03 +0000

Respiratory syncytial virus vaccine; soln for IM inj after reconstitution; preservative-free.

Abrysvo Efficacy in Older Adults Consistent Over Two RSV Seasons

Steve Duffy — Thu, 29 Feb 2024 17:45:00 +0000

Abrysvo (respiratory syncytial virus vaccine) demonstrated consistent vaccine efficacy against respiratory syncytial virus (RSV)-associated lower respiratory tract disease (LRTD) in adults 60 years of age and older over 2 seasons, according to results from the ongoing phase 3 RENOIR trial.

The randomized, double-blind, placebo-controlled RENOIR trial (ClinicalTrials.gov Identifier: NCT05035212) evaluated the efficacy and safety of Abrysvo in more than 37,000 adults 60 years of age and older. Findings during the first season showed vaccine efficacy of 88.9% (95% CI, 53.6-98.7) against RSV-associated LRTD with at least 3 symptoms and 65.1% (95% CI, 35.9-82.0) against RSV-associated LRTD with at least 2 symptoms.

After the end of season 2, vaccine efficacy was reported to be 77.8% (95% CI, 51.4-91.1) against RSV-associated LRTD with at least 3 symptoms and 55.7% (95% CI, 34.7-70.4) against RSV-associated LRTD with at least 2 symptoms. Across both seasons, vaccine efficacy against RSV-associated LRTD with at least 3 symptoms was 81.5% (95% CI, 63.3-91.6) after approximately 16.4 months of disease surveillance.

As for safety, no new vaccine-related adverse events were reported through the second RSV season.

“We are encouraged by the level of protection that we observed after 2 full RSV seasons for Abrysvo,” said Annaliesa Anderson, PhD, Senior Vice President and Chief Scientific Officer, Vaccine Research and Development, Pfizer. “This new data indicate that broad and durable protection against both types of RSV that cause disease, RSV A and RSV B, is the potential benefit to having a bivalent vaccine.”

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Abrysvo is currently approved for the prevention of LRTD caused by RSV in individuals 60 years of age and older. It is also indicated for active immunization of pregnant individuals at 32 through 36 weeks gestational age for the prevention of LRTD and severe LRTD caused by RSV in infants from birth through 6 months of age.

ACAM2000

Haymarket Media — Thu, 06 Apr 2023 15:15:36 +0000

Smallpox (vaccinia) vaccine, live; contains 2.5–12.5×10^5 plaque forming units; per 0.0025mL dose; lyophilized pwd for percutaneous scarification after reconstitution; contains trace amounts of neomycin, polymyxin B.

Accelerated Hepatitis B Vaccination Appears Safe, Effective in CKD

Natasha Persaud — Tue, 16 Apr 2024 14:00:00 +0000

Completing hepatitis B virus vaccination (HBV) in 8 weeks rather than the standard 24 weeks improves seroconversion rates among patients with advanced chronic kidney disease (CKD), investigators report. Other research suggests that patients with IgA nephropathy with hepatitis B infection are at increased risk for progression.

“Hepatitis B virus vaccination is crucial for seronegative patients with advanced chronic kidney disease for protection during dialysis while preparing for transplantation,” according to Natavudh Townamchai, MD, of Chulalongkorn University and King Chulalongkorn Memorial Hospital in Bangkok, Thailand, and colleagues.

The investigators conducted a randomized controlled trial of patients with an estimated glomerular filtration rate (GFR) less than 30 mL/min/m², including those on dialysis. The standard HBV vaccination group received the Engerix B (40 μg) at 0, 4, 8, and 24 weeks. The accelerated group received the same 40 μg dose at 0, 1, 4, and 8 weeks. The 40μg dose is double the standard dosage given to the general population and is recommended in CKD guidelines.

Seroconversion was defined as titers of hepatitis B surface antibodies (anti-HBs) of 10 IU/L or higher. In intent-to-treat analyses of 133 patients, the accelerated group had significantly higher rates of seroconversion at 12 weeks compared with the standard group (83.08% vs 63.24%), Dr Townamchai’s team reported in Kidney International Reports. The accelerated group also exhibited a significantly higher seroconversion rate at 12 weeks (85.71% vs. 69.35%) in the per-protocol analysis of 125 patients. Based on the per-protocol analysis, for every 100 accelerated vaccinations, an additional 16 seroconversions would be expected compared with the standard vaccination schedule.

By 28 and 52 weeks, the seroconversion rates were similar between groups showing that the accelerated regimen produced a durable response. Rates of anti-HBs of 100 IU/L or greater correlate with longer protection. The investigators suggested that patients with anti-HBs titers below 100 IU/L should consider a booster HBV vaccination after 28 weeks.

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No serious adverse events, such as anaphylaxis, occurred in the accelerated group.

“Seroconversion of anti-HBs in response to the vaccination can protect patients from HBV infection during dialysis and enable them to receive a kidney from an HBsAg-positive donor,” Dr Townamchai’s team pointed out.

IgA Nephropathy Progression

In a separate study of 1961 patients with biopsy-proven IgA nephropathy published in Kidney International Reports, Xu-jie Zhou, MD, of Peking University First Hospital, Peking University Institute of Nephrology, in Beijing, China, and colleagues reported that chronic hepatitis B infection significantly increased the risk for disease progression by 74%.

Use of antiviral medications against hepatitis B and resolved infection were not associated with the outcome. The presence of hepatitis B virus deposits in the kidney also did not appear prognostic.

“Our findings highlight the importance of considering HBV infection status when managing patients with IgAN and call for further research to elucidate underlying mechanisms and investigate potential benefits of targeted antiviral therapy in individuals with concomitant HBV infection and IgAN,” the investigators concluded.

Acetaminophen Use Linked to Adverse Outcomes in Acute Hepatitis A

Meahjabeen Hoque — Tue, 16 May 2023 15:49:02 +0000

Treatment with acetaminophen is associated with adverse outcomes among individuals with acute hepatitis A (AHA), according to study findings published in Digestive and Liver Disease.

Researchers sourced data from health insurance claims of individuals diagnosed with AHA. The researchers also collected information on patients’ exposure to acetaminophen and assessed complications.

The study defined exposure to acetaminophen as any prescription claims for acetaminophen-containing drugs during the AHA episode. Participants were assessed for adverse outcomes, defined as implementing renal replacement therapy, encephalopathy and/or brain edema, respiratory failure, and liver transplantation.

Investigators identified 43,500 eligible individuals from the data. They used Fisher’s exact test and the Mann-Whitney test to address and categorize variables. They performed univariable and used multivariable logistic regression analyses, and they performed propensity score matching using psmatch2 of STATA. SAS 9.4 or STATA ver. 14.2 were used for statistical analysis.

“

[O]ur nationwide cohort of AHA revealed an association between APAP exposure and increased adverse outcomes compared to NSAID control.

Adverse outcomes were identified in 593 of 43,500 patients (1.4%). Renal replacement therapy was the most common adverse event (n=418), followed by hepatic encephalopathy and/or brain edema (n=208), mechanical ventilation (n=178), and liver transplantation (n=55).

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The researchers noted that exposure to acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) was associated with an increase in adverse outcomes (odds ratio [OR], 5.66; 95% CI, 5.63-5.69) and for acetaminophen and NSAIDs exposure (OR, 2.90; 95% CI, 2.88-2.92).

Investigators examined participants who had exclusive exposure to acetaminophen (n=9,134) vs those with exclusive exposure to NSAIDs (n=2,636). The acetaminophen-only group showed a higher proportion of hospitalization than the NSAID-only group (98.8% vs 92.4%; P <.0001). The acetaminophen-only groups had more adverse outcomes than the NSAID-only group (2.7% vs 2.0%; P = .030).

The results were consistent when controlling for variables such as age, sex, and other health conditions.

Study limitations include a lack of specificity about participants and potential inaccuracies in the data due to the nature of drawing information from claims data.

“In conclusion, our nationwide cohort of AHA revealed an association between APAP [acetaminophen] exposure and increased adverse outcomes compared to NSAID control,” study authors wrote.

ACIP Recommends Chikungunya Vaccine Ixchiq for Travelers, Lab Workers

Steve Duffy — Thu, 29 Feb 2024 18:55:00 +0000

The US Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) recommends the use of Ixchiq^® vaccine for the prevention of disease caused by the chikungunya virus in individuals 18 years of age and older who are at increased risk of exposure.

Ixchiq is recommended for the following individuals:

Adults 18 years of age and older traveling to a country or territory where there is a chikungunya outbreak.
Laboratory workers with potential for exposure to chikungunya.

Additionally, Ixchiq may be considered for the following individuals traveling to a country or territory without an outbreak but with evidence of chikungunya transmission within the last 5 years:

Persons aged 65 years and older, particularly those with underlying medical conditions, who are likely to have at least moderate exposure to mosquitoes (at least 2 weeks [cumulative] of exposure to mosquitoes in indoor or outdoor settings).
Persons staying for a cumulative period of 6 months or more.

Chikungunya is a mosquito-borne viral disease caused by the chikungunya virus (CHIKV), a Togaviridae virus. While the mortality rate is very low with CHIKV infection, morbidity is high with debilitating long-term symptoms. Ixchiq is a live-attenuated, single-dose vaccine designed to delete a part of the CHIKV genome.

The vaccine received accelerated approval in November 2023 based on safety and immunogenicity data from two phase 3 trials which were conducted in North America and included a total of 4115 adults.

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Juan Carlos Jaramillo, MD, Chief Medical Officer of Valneva, commented, “Chikungunya poses a significant risk to individuals journeying to or residing in regions where the chikungunya virus and its mosquito vectors thrive. Ixchiq offers advantages to travelers on vacation and visiting family and to people engaged in business ventures, missions, or laboratory duties. We embrace the ACIP endorsement, marking Ixchiq^® as the only approved and recommended vaccine for the target population. We will continue collaborating with regulatory authorities worldwide to increase the accessibility of Ixchiq^® across regions.”

Ixchiq is available in a carton containing a single-dose vial of lyophilized antigen component and diluent. Following reconstitution, treatment is administered as a single 0.5mL dose via intramuscular injection.

ACIP Votes for Routine Use of Jynneos in Adults at Risk of Mpox Infection

Steve Duffy — Tue, 05 Dec 2023 16:15:00 +0000

The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) has voted in favor of routine use of Jynneos^® (smallpox and monkeypox vaccine, live, nonreplicating) for the prevention of mpox disease in adults 18 years of age and older determined to be at high risk for mpox infection. Previously, the ACIP had recommended the vaccine for use only during an outbreak.

Originally approved in 2019, Jynneos was developed in collaboration with the US government to ensure a supply of a smallpox vaccine for the entire population. During the mpox outbreak in 2022, the US Department of Health and Human Services (HHS) expanded access to Jynneos to mitigate the spread of the infection, while the Food and Drug Administration (FDA) granted emergency use authorization for intradermal injection in individuals 18 years of age and older and subcutaneous injection in those younger than 18 years of age who were determined to be at high risk.

“Since the outbreak of mpox last year, Bavarian Nordic has supplied millions of doses of our vaccine to more than 70 countries worldwide, which has had a positive impact on controlling this unprecedented outbreak of mpox,” said Paul Chaplin, President and CEO of Bavarian Nordic. “The broadened ACIP recommendation recognizes the significance of maintaining a high awareness of the disease among risk groups and the importance of ensuring broader access to the vaccine beyond an outbreak situation.”

The recommendation has been adopted by the Director of the CDC and is now included in the 2024 adult immunization schedule. Bavarian Nordic intends to launch Jynneos in the US in the first half of 2024.

“Entering the private mpox vaccine market in the US offers an opportunity to provide improved access to Jynneos and to build a steady commercial business segment, complimenting the existing smallpox stockpiling business with the US government,” added Chaplin.

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Jynneos is administered by subcutaneous injection as 2 doses (0.5mL each) 4 weeks apart. Each vial contains a single dose (0.5mL).

Last Reviewed: December 5, 2023

ACIP: 2023 Adult Immunization Schedule Updates

Diana Ernst, RPh — Fri, 10 Feb 2023 17:30:00 +0000

The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) has released an updated version of the adult immunization schedule for ages 19 years and older in the United States.

The immunization schedule has been approved by CDC, the American College of Physicians, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, the American College of Nurse-Midwives, the American Academy of Physician Associates, the American Pharmacists Association, and the Society for Healthcare Epidemiology of America.

Major changes to the adult immunization schedule for 2023 include the following:

COVID-19 Vaccination

Recommendations for administration of the primary series in the general population and in individuals who are moderately to severely immunocompromised has been added.
Information on booster doses, preexposure prophylaxis, and recommendations for Janssen COVID-19 vaccine recipients have also been added.

Hepatitis B Vaccination

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PreHevbrio has been added to the schedule. The vaccine is administered as a 3-dose series via intramuscular injection on a 0-, 1- and 6-month schedule. It is not recommended in pregnancy due to lack of safety data.
New addition: Persons 60 years of age and older with known risk factors for hepatitis B virus (HBV) infection should complete a HepB vaccine series, while those without known risk factors for HBV infection may complete a HepB vaccine series.

Influenza Vaccination

Recommendations for the 2022-2023 influenza season were added.
Language added to routine vaccination section that states quadrivalent high-dose inactivated influenza vaccine, quadrivalent recombinant influenza vaccine, or quadrivalent adjuvanted inactivated influenza vaccine is preferred for adults aged 65 years or older. If unavailable, then any other age-appropriate influenza vaccine should be used for this age group.
Addition to Special Situations section: Live attenuated influenza vaccines should not be administered to close contacts of immunosuppressed persons who require a protected environment.

MMR Vaccination

Recommendations for additional MMR doses in a mumps outbreak setting have been added.

Meningococcal Vaccination

Trumenba^®: If the third dose is administered earlier than 4 months after the second dose, a fourth dose should be administered at least 4 months after the third dose.

Pneumococcal Vaccination

New recommendations for the use of PCV15 and PCV20 in persons who previously received pneumococcal vaccines.
PneumoRecs VaxAdvisor mobile app developed to help providers determine which pneumococcal vaccines a patient needs.

Poliovirus Vaccination

Recommendations for adults who are at increased risk of exposure to polioviruses have been added.

Zoster Vaccination

A note has been added stating that serologic evidence of prior varicella is not necessary for zoster vaccination. If serologic evidence of varicella susceptibility becomes available, follow ACIP guidelines for varicella vaccination first.
Immunocompromised: If there is no documented history of varicella, varicella vaccination, or herpes zoster, refer to the clinical considerations for use of recombinant zoster vaccine and the ACIP varicella vaccine recommendations for further guidance.

For additional guidance on the use of each vaccine appearing in the schedule, including precautions and contraindications, clinicians can view the respective ACIP vaccine recommendations at cdc.gov.

Reference

Murthy N, Wodi AP, McNally V, et al. Advisory Committee on Immunization Practices recommended immunization schedule for adults aged 19 years or older — United States, 2023. Published online February 10, 2023. MMWR. dx.doi.org/10.15585/mmwr.mm7206a2

ACIP: 2023 Child and Adolescent Immunization Schedule Updates

Diana Ernst, RPh — Fri, 10 Feb 2023 16:40:00 +0000

The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) has released the recommended child and adolescent immunization schedule for ages 18 years or younger in the United States for 2023.

The immunization schedule has been approved by CDC, the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, the American College of Nurse-Midwives, the American Academy of Physician Associates, and the National Association of Pediatric Nurse Practitioners.

Major changes to the child and adolescent immunization schedule for 2023 include the following:

COVID-19 Vaccination

Recommendations for administration of the primary series in the general population and in individuals who are moderately to severely immunocompromised have been added.
Information on booster doses, preexposure prophylaxis, and recommendations for Janssen COVID-19 vaccine recipients have also been added.

Dengue Vaccination

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New addition: Dengue vaccination should not be administered to children traveling to or visiting endemic dengue areas.

Hepatitis B Vaccination

Recommendations for infants born to mothers who are hepatitis B surface antigen (HBsAg) positive, or whose HBsAg is unknown were added.
Catch-up vaccination for persons 18 years of age: Heplisav-B^® and PreHevbrio^® vaccines added.

Influenza Vaccination

Recommendations for the 2022-2023 influenza season were added.
Addition to Special Situation section: Live attenuated influenza vaccines should not be administered to close contacts of immunosuppressed persons who require a protected environment.

MMR Vaccination

Recommendations for additional MMR doses in a mumps outbreak setting have been added.

Meningococcal ACWY Vaccination

Updated to state that Menveo^® one-vial (all liquid) formulation should not be administered before age 10 years.

MenB Vaccination

Recommendations for when the second or third dose of Trumenba^® is administered earlier or later than the recommended minimum intervals have been added.

Pneumococcal Vaccination

Recommendations for use of 15-valent pneumococcal conjugate vaccine (PCV15) have been added.

Poliovirus Vaccination

Recommendations for adolescents aged 18 years who are at increased risk of exposure to polioviruses have been added.

For additional guidance on the use of each vaccine appearing in the schedule, including precautions and contraindications, clinicians can view the respective ACIP vaccine recommendations at cdc.gov. In addition, vaccine catch-up guidance can be found here.

Reference

Wodi AP, Murthy N, McNally V, et al. Advisory Committee on Immunization Practices recommended immunization schedule for children and adolescents aged 18 years or younger — United States, 2023. Published online February 10, 2023. MMWR. dx.doi.org/10.15585/mmwr.mm7206a1

ACIP: 2024 Adult Immunization Schedule Updates

Steve Duffy — Fri, 17 Nov 2023 21:50:00 +0000

Major changes to the adult immunization schedule for 2024 include the following:

COVID-19 Vaccination

Guidance has been revised to include use of the updated COVID-19 vaccines (2023-2024 formula).

Hepatitis A Vaccination

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Revised note clarifies that any individual who is not fully vaccinated and requests vaccination can receive hepatitis A vaccination.

Hepatitis B Vaccination

Risk-based vaccination recommendations for individuals 60 years of age and older have been updated.
A recommendation for shared clinical decision making has been added for individuals 60 years of age and older with diabetes.

Human Papillomavirus (HPV) Vaccination

Update to routine vaccination section: No additional doses are recommended for individuals who have completed the HPV vaccine series with any valency using the recommended dosing intervals.

Influenza Vaccination

Note has been added to the Special Situations section stating that persons with an egg allergy can receive any influenza vaccine (egg-based and non-egg-based) appropriate for age and health status.

Meningococcal Vaccination

Menactra (MenACWY-D) has been removed from all sections.
Penbraya (meningococcal groups A, B, C, W and Y vaccine) has been added to the schedule for active immunization to prevent invasive disease caused by Neisseria meningitidis serogroups A, B, C, W, and Y in individuals 10 through 25 years of age.

Mpox Vaccination

Guidance on the use of Jynneos (smallpox and monkeypox vaccine, live, nonreplicating) in adults based on sexual risk factors has been added.

Pneumococcal Vaccination

Guidance on determining which pneumococcal vaccines a patient needs and the minimum intervals between doses has been revised to provide additional clarity.

Poliovirus Vaccination

Routine recommendation updated to state that adults who are known or suspected to be unvaccinated or incompletely vaccinated should complete the 3-dose IPV primary series.
Recommendations for adults who have completed the primary series and are at increased risk for exposure to poliovirus have been included.

Respiratory Syncytial Virus (RSV) Vaccination

Information added on routine RSV vaccination during pregnancy; Abrysvo is the only RSV vaccine recommended for use during pregnancy.
Guidance has been added on shared clinical decision making for individuals aged 60 years or older; Arexvy or Abrysvo may be used.
Guidance for providers in jurisdictions with RSV seasonality that differs from most of the continental US has been added.
A note has been included listing the risk factors and medical conditions that increase a patient’s risk for severe RSV disease.

For additional guidance on the use of each vaccine appearing in the schedule, including precautions and contraindications, clinicians can view the respective ACIP vaccine recommendations at CDC.gov.

ACIP: 2024 Child and Adolescent Immunization Schedule Updates

Steve Duffy — Fri, 17 Nov 2023 20:30:17 +0000

Major changes to the child and adolescent immunization schedule for 2024 include the following:

COVID-19 Vaccination

Guidance has been revised to include use of the updated COVID-19 vaccines (2023-2024 formula).

Human Papillomavirus (HPV) Vaccination

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Update to routine vaccination section: No additional doses are recommended for individuals who have completed the HPV vaccine series with any valency using the recommended dosing intervals.

Influenza Vaccination

Note has been added to the Special Situations section stating that persons with an egg allergy can receive any influenza vaccine (egg-based and non-egg-based) appropriate for age and health status.

Measles, Mumps, and Rubella Vaccination

Note has been added to routine and catch-up vaccination stating that if MMRV (measles, mumps, rubella, varicella vaccine) is used, the minimum interval between MMRV doses is 3 months.

Meningococcal Vaccination

Menactra (MenACWY-D) has been removed from all sections.
Penbraya (meningococcal groups A, B, C, W and Y vaccine) has been added to the schedule for active immunization to prevent invasive disease caused by Neisseria meningitidis serogroups A, B, C, W, and Y in individuals 10 through 25 years of age.

Mpox Vaccination

Guidance on the use of Jynneos (smallpox and monkeypox vaccine, live, nonreplicating) in adolescents aged 18 years based on sexual risk factors has been added.

Pneumococcal Vaccination

13-valent pneumococcal conjugate vaccine (PCV13) has been removed from the schedule.
New recommendations for use of PCV15 (15-valent pneumococcal conjugate vaccine), PCV20 (20-valent pneumococcal conjugate vaccine), and PPSV23 (pneumococcal 23-valent polysaccharide vaccine) have been added.
The list of conditions that increase invasive pneumococcal disease now includes chronic kidney disease, chronic liver disease, and moderate persistent or severe persistent asthma.

Poliovirus Vaccination

Updated recommendations for individuals 18 years of age have been added to the Catch-up section.
Recommendations for individuals 18 years of age who have completed the primary series and are at increased risk for exposure to poliovirus have been included.

Respiratory Syncytial Virus (RSV) Vaccination/Immunization

Details on the use of nirsevimab (Beyfortus) have been provided, as well as information describing the timing of immunization.
Details on the use of RSV vaccine during pregnancy have been included; Abrysvo is the only RSV vaccine recommended for use during pregnancy.
Guidance for providers in jurisdictions with RSV seasonality that differs from most of the continental US has been added.

Tetanus, Diphtheria, and Pertussis (Tdap) Vaccination

Revised note clarifies that the Tdap dose recommended at age 11-12 years is the adolescent Tdap booster dose.

For additional guidance on the use of each vaccine appearing in the schedule, including precautions and contraindications, clinicians can view the respective ACIP vaccine recommendations at CDC.gov. In addition, vaccine catch-up guidance can be found here.

ACIP: Updated Vaccine Guidance for the 2023-2024 Influenza Season

Steve Duffy — Thu, 24 Aug 2023 15:45:00 +0000

The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices has issued new guidelines for the prevention and control of seasonal influenza with vaccines for the 2023-2024 season. Routine annual influenza vaccination is recommended for all patients 6 months of age and older who have no contraindications. Vaccination should ideally be completed by October though it should be offered throughout the season if influenza viruses continue to circulate.

For the 2023–2024 season, all influenza vaccines are expected to be quadrivalent, containing hemagglutinin (HA) derived from one influenza A(H1N1)pdm09 virus, one influenza A(H3N2) virus, one influenza B/Victoria lineage virus, and one influenza B/Yamagata lineage virus.

Egg-based influenza vaccines:

Will contain HA derived from an influenza A/Victoria/4897/2022 (H1N1)pdm09-like virus, an influenza A/Darwin/9/2021 (H3N2)-like virus, an influenza B/Austria/1359417/2021 (Victoria lineage)-like virus, and an influenza B/Phuket/3073/2013 (Yamagata lineage)-like virus.
These include Afluria Quadrivalent, Fluarix Quadrivalent, FluLaval Quadrivalent, Fluzone Quadrivalent (all standard dose), Fluzone High-Dose Quadrivalent (high-dose formulation), Fluad Quadrivalent (standard dose with MF59 adjuvant), and FluMist Quadrivalent intranasal spray.

Cell culture-based inactivated or recombinant influenza vaccines:

Will contain HA derived from an influenza A/Wisconsin/67/2022 (H1N1)pdm09-like virus, an influenza A/Darwin/6/2021 (H3N2)-like virus, an influenza B/Austria/1359417/2021 (Victoria lineage)-like virus, and an influenza B/Phuket/3073/2013 (Yamagata lineage)-like virus.
These include Flucelvax Quadrivalent (standard dose cell culture-based) and Flublok Quadrivalent (recombinant).

Updates to the guidance for this upcoming influenza season include the following:

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ACIP recommends all persons 6 months of age and older with egg allergy receive influenza vaccine (egg-based or nonegg-based) that is otherwise appropriate for the recipient’s age and health status.
- It is no longer recommended that individuals who have had an allergic reaction to egg with symptoms other than urticaria should be vaccinated in a medical setting supervised by a health care provider who is able to recognize and manage severe allergic reactions if an egg-based vaccine is used.
- Egg allergy alone does not require additional safety measures for influenza vaccination beyond those recommended for any recipient of any vaccine, regardless of severity of previous reaction to egg.
- All vaccines should be administered in settings in which personnel and equipment needed for rapid recognition and treatment of acute hypersensitivity reactions are available.
- Additional information about this recommendation can be found here.

Regarding simultaneous administration of influenza vaccine with the new respiratory syncytial virus (RSV]) vaccine, data included in the prescribing information for GSK’s Arexvy show no evidence for interference in the immune response to any of the antigens contained in both concomitantly administered vaccines. In this study (ClinicalTrials.gov Identifier: NCT04841577), participants 60 year of age and older received 1 dose of Arexvy and Fluarix Quadrivalent. The criteria for noninferiority of the immune responses in the control vs coadministration group were met, though RSV and influenza antibody titers were somewhat lower with coadministration; the clinical significance of this is unknown.

The full report, which includes guidance for influenza vaccination of specific populations (eg, children, pregnant people, older patients, immunocompromised individuals), and situations (eg, history of Guillain-Barré Syndrome) can be found here.

ACTHIB

Haymarket Media — Wed, 05 Apr 2023 18:51:26 +0000

Haemophilus b conjugate 10mcg (tetanus toxoid conjugate) per 0.5mL; pwd for IM inj after reconstitution with saline.

Ad26.RSV.preF-RSV preF Protein Vaccine Immunogenic in Seniors

Haymarket Media — Thu, 16 Feb 2023 14:00:00 +0000

HealthDay News — An adenovirus serotype 26 respiratory syncytial virus (RSV) vector encoding a prefusion F (preF) protein (Ad26.RSV.preF) in combination with RSV preF protein is immunogenic and prevents RSV-mediated lower respiratory tract disease in older adults, according to a study published in the February 16 issue of the New England Journal of Medicine.

Ann R. Falsey, MD, from the University of Rochester School of Medicine in New York, and colleagues conducted a phase 2b, proof-of-concept trial to examine the efficacy, immunogenicity, and safety of Ad26.RSV.preF-RSV preF protein vaccine among adults aged 65 years or older. A total of 5782 participants were randomly assigned to receive vaccine or placebo in a 1:1 ratio. The primary end point was the first occurrence of RSV-mediated lower respiratory tract disease that met one of three case definitions.

The researchers found that RSV-mediated lower respiratory tract disease meeting case definitions 1, 2, and 3 occurred in six, 10, and 13 and in 30, 40, and 43 vaccine and placebo recipients, respectively. For case definitions 1, 2, and 3, vaccine efficacy was 80.0, 75.0, and 69.8%, respectively. From baseline to day 15 after vaccination, RSV A2 neutralizing antibody titers increased by a factor of 12.1. Compared with the placebo group, the percentages of participants with solicited local and systemic adverse events were higher in the vaccine group (local: 37.9 vs 8.4%; systemic: 41.4 vs 16.4%); most adverse events were mild to moderate. The frequency of serious adverse events was similar between the groups.

“Vaccine efficacy, immunogenicity, and safety were maintained across subgroups defined according to age and the presence of additional risk factors for severe RSV-mediated disease,” the authors write.

The study was funded by Janssen Vaccines and Prevention, which manufactures the Ad26.RSV.preF-RSV preF vaccine.

ADACEL

Haymarket Media — Thu, 20 Jul 2023 13:45:49 +0000

Tetanus and reduced diphtheria toxoids, acellular pertussis vaccine; aluminum phosphate adsorbed; susp for IM inj; contains 2-phenoxyethanol and traces of formaldehyde, glutaraldehyde.

Adacel Approved for Use During Pregnancy to Prevent Pertussis in Infants

Diana Ernst, RPh — Wed, 11 Jan 2023 19:30:00 +0000

The Food and Drug Administration (FDA) has approved Adacel^® (tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine, adsorbed [Tdap]) for immunization during the third trimester of pregnancy to prevent pertussis in infants younger than 2 months of age.

The approval was based on a re-analysis of data from on observational study of Tdap vaccine effectiveness in the US (ClinicalTrials.gov Identifier: NCT05040802). Adacel was estimated to be 88% (95% CI, 43.8-97.4) effective in preventing pertussis in infants younger than 2 months when administered during the third trimester of pregnancy and at least 14 days before delivery based on data from 101 cases of pertussis in infants younger than 2 months of age (including 5 infants whose mothers received Adacel during the third trimester and ≥14 days before delivery) and 171 controls (including 27 infants whose mothers received Adacel during the third trimester and ≥14 days before delivery).

The FDA also reviewed data from a retrospective passive surveillance study (ClinicalTrials.gov Identifier: NCT00258882) that included women who received Adacel during pregnancy (n=225) and controls (n=675). Findings suggest that the rates of major birth defects and miscarriage in women who receive Adacel within 30 days prior to pregnancy or during pregnancy are consistent with estimated background rates. There were 21 reports of spontaneous abortion (9.3%) and 15 congenital anomalies (6.7%) in the Adacel exposed group, and 102 spontaneous abortions (15%) and 57 congenital anomalies (8.4%) in the control group.

Adacel is administered as a single 0.5mL intramuscular injection. To prevent pertussis in infants younger than 2 months of age, Adacel should be administered to pregnant individuals during the third trimester of pregnancy. Pregnancy outcomes in women exposed to Adacel during pregnancy are monitored through a pregnancy exposure registry. Patients and health care providers are encouraged to contact Sanofi Pasteur at (800) 822-2463 or online at www.sanofipasteurpregnancyregistry.com.

Adacel is also indicated for active booster immunization against tetanus, diphtheria and pertussis in individuals 10 through 64 years of age.

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Reference

Adacel. Package insert. Sanofi Pasteur Inc; 2023. Accessed January 11, 2023. https://www.fda.gov/media/119862/download.

Advantaged Households Have Lower Intent to Vaccinate Teens Against HPV

Haymarket Media — Mon, 04 Mar 2024 14:00:00 +0000

HealthDay News — A significant proportion of adolescents who are unvaccinated or not fully vaccinated against human papillomavirus (HPV) are from advantaged socioeconomic households, according to a study published online February 19 in The Lancet Regional Health: Americas.

Kalyani Sonawane, from the Medical University of South Carolina in Charleston, and colleagues compared the factors associated with parental HPV vaccination intentions between socioeconomically divergent groups. The analysis included data from 212,643 adolescents (105,958 unvaccinated or not fully vaccinated) participating in the 2017 to 2021 National Immunization Survey-Teen.

The researchers found that in the advantaged group, 64.7% of parents of unvaccinated adolescents (equating to 2.4 million US adolescents) had no intention to initiate the HPV vaccine vs 40.9% of parents in the deprived group (equating to 0.2 million adolescents). In the advantaged group, the most frequent reason for lacking intent was “safety concerns” (25.5%), whereas in the deprived group, “lack of knowledge,” “not recommended,” and “not needed” were common reasons (nearly 15% each). The advantaged group had a higher lack of intent to complete the HPV vaccine series (43.9%; 1.1 million adolescents) versus the deprived group (25.2%; 0.08 million adolescents). More than half in the advantaged group (58.4%) and more than one-third in the deprived group (37.1%) cited “already up to date” as the primary reason for not completing the HPV vaccine series.

“Interventions that provide facts on vaccine safety and effectiveness and debunk HPV vaccine myths at an individual- and/or community-level, along with strong recommendations by health care providers, will be necessary to avoid stagnation of HPV vaccine rates and to continue making progress towards achieving the 80% national goal,” the authors write.

One author disclosed ties to Merck.

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Abstract/Full Text

Adverse Events Detailed for Teen COVID-19 Vaccination Program

Haymarket Media — Mon, 24 Apr 2023 14:00:00 +0000

HealthDay News — For adolescents aged 12 to 17 years, most reported adverse events following BNT162b2 vaccination are mild and self-limited, according to a study published online April 21 in Pediatrics.

Elizabeth M. Hesse, MD, from the US Centers for Disease Control and Prevention in Atlanta, and colleagues conducted descriptive analyses using data from 2 complementary US vaccine safety monitoring systems: v-safe and the Vaccine Adverse Event Reporting System (VAERS). Adverse events were detailed for the first full year of the U.S. COVID-19 vaccination program for adolescents aged 12 to 17 years.

The researchers found that most reported reactions following BNT162b2 vaccination were mild to moderate among the 172,032 adolescents aged 12 to 17 years enrolled in v-safe; reactions were most often reported on the day after vaccination and were more common after dose 2. Overall, 20,240 adverse event reports were received by VAERS, 91.5% of which were nonserious. Forty cases of multisystem inflammation syndrome in children were verified (1.2 cases per million vaccinations); of these, 85% had evidence of prior SARS-CoV-2 infection. There were 570 cases of myocarditis (17.7 cases per million vaccinations); at the time of report, 77% reported symptom resolution.

“Our findings provide additional evidence to support the US COVID-19 vaccination program in adolescents to prevent COVID-19 and its serious complications,” the authors write.

Abstract/Full Text

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