By: Gabrielle Flavoni, PharmD Candidate c/o 2018
The release of this year’s updated immunization schedule has sent a buzz throughout the healthcare industry. From small changes in the footnotes to an addition to an entire new table, the Advisory Committee on Immunization Practices (ACIP) has done what it could to clarify the guidelines, while also making it easier to read.1 In ACIP’s October meeting, members came together to vote on changes for this year’s guidelines, and has since been backed with the FDA’s approval.1
The first set of changes were made to the footnotes of the guidelines. In general, the footnotes were simplified and organized in a more standardized, condensed manner. The “Additional Information” footnote was moved to the cover page to better organize the information, and the general formatting of the footnotes was heavily revised.2
The second set of changes were made to the adult vaccination schedule itself. 3
The changes are presented as the following:
¨ Hepatitis B: Suggests that a monovalent birth dose should be given to all newborns within 24 hours of being born.3
¨ Haemophilus influenzae Type b: This Comvax vaccine was removed since it is no longer available for use.3
¨ Pneumococcal conjugate: PCV7 vaccine was removed since all children who received PCV7 in their primary series have now exited that age range
¨ Influenza: Low effectiveness of the live attenuated influenza vaccine (LAIV) has been shown and is not recommended for 2016-2017 flu season.3
¨ Meningococcal ACWY: This vaccine is now promoted for adults with HIV for 2017. Adults who are at risk due to a meningococcal disease outbreak should also receive 1 dose of this vaccine.3
¨ Meningococcal B: Directions have been added concerning people 16-23. The new guidelines state that they may be vaccinated with discretion from health care providers. Also, three doses of this vaccine are recommended at 0, 1-2, and 6 month intervals for adults who are at an increased risk for meningococcal disease.3
¨ Tdap: Pregnant women are now recommended to receive a dose as early as 27-36 weeks.3
¨ HPV: New revisions indicate that the dose recommended is based on the age of the patient being vaccinated. Two doses is advised for people before their 15th birthday, yet three doses are recommended if the person has specific immunocompromised conditions listed within the section. Also, if females or males have not received these vaccines by 26 years old and 21 years old respectively, they are to be given a three-dose series of vaccinations at designated monthly intervals.3
The third set of changes were to Figures 1 and 2 of the Birth to Adolescent Schedule:
¨ In Figure 1, a column has been added for adolescents who are of 16 years of age. They have separated the 16 year old age block from the 17 and 18 year-olds in order to further emphasize the importance of men receiving the meningococcal conjugate vaccine (MenACWY) booster by the age of 16. A blue bar was also added to the HPV vaccine indicating that the vaccine is still safe to receive even in the absence of a high-risk condition.4
¨ In both figures, the standardized acronyms for vaccines are now used in order to simplify the information presented, and colored blocks are used to make the chart more visually pleasing; both lead to enhanced consistency and readability.5
¨ In Figure 2, the topic columns within the chart have been reorganized in order to have a better flow of information. Related topics were placed together, and special populations were linked together. They also changed the color block for MenACWY for HIV infection from purple to yellow.6
- Advisory Committee on Immunization Practices. Centers for Disease. Control and Prevention. https://www.cdc.gov/vaccines/acip/about.html. Published 08/16/2012. Last Updated 04/15/2016.
- Kim D. Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older — United States, 2017. Centers for Disease Control and Prevention. https://www.cdc.gov/mmwr/volumes/66/wr/mm6605e2.htm. Published 02/10/2017
- Meissner C. New table among changes to 2017 immunization schedules. AAP News & Journals. http://www.aappublications.org/news/2017/02/06/Immunization020617. Published 02/06/2017.
- CDC, AAFP Release 2017 Immunization Schedules. AAFP. http://www.aafp.org/news/health-of-the-public/20170206immunskeds.html. Published 02/06/2017.
- Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/schedules/downloads/adult/adult-combined-schedule.pdf. Published 02/01/2017.
- Recommended Adult Immunization Schedule-United States-2016. Center for Disease Control and Prevention. https://www.cdc.gov/vaccines/schedules/downloads/adult/adult-schedule.pdf. Published 02/03/2016.