Technically Speaking: Important New Vaccine Recommendations From CDC's Feb. 2015 Meeting

Published on Apr 24, 2015

The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention meets three times a year, most recently in February. Several important vaccine recommendations were voted upon. ACIP-approved recommendations do not become official until they are approved by the CDC director and published in the Morbidity and Mortality Weekly Report (MMWR). The following provides a summary of the decisions voted upon at the meeting.

Influenza vaccine

ACIP voted to approve its annual influenza vaccine recommendations for the 2015–2016 influenza season. The committee reaffirmed the need for annual influenza vaccination for all people age 6 months and older. Based on new data, ACIP removed the previously recommended preference for the use of live attenuated influenza vaccine (LAIV, FluMist®, AstraZeneca) in children age 2 through 8 years, noting that both LAIV and inactivated influenza vaccine (IIV) are equally acceptable to use in this age group. CDC issued a related media statement on February 26.

Meningococcal B vaccine

ACIP voted that a serogroup B meningococcal vaccine (MenB; Bexsero®, GSK; Trumenba®, Pfizer) series should be administered to people 10 years of age and older who are at increased risk of meningococcal disease. These individuals include:

People with persistent complement component deficiencies, including inherited or chronic deficiencies in C3, C5-9, properdin, factor D, factor H, or taking eculizumab
People with anatomic or functional asplenia, including sickle cell disease
Microbiologists routinely exposed to isolates of Neisseria meningitides
People identified to be at increased risk because of a meningococcal B outbreak

No preference was stated for the use of one MenB vaccine over the other.

Both vaccines are licensed by the Food and Drug Administration (FDA) for use in people ages 10 through 25 years, so administering the vaccine to people age 26 years or older is off-label but recommended by ACIP for people in that age group who are at increased risk for meningococcal disease.

ACIP delayed discussion of routine use of MenB in adolescents and college students until its June meeting.

Human papillomavirus vaccine

ACIP voted to add the newly licensed 9-valent human papillomavirus vaccine (9vHPV, Gardasil® 9, Merck) to the vaccines available for use within the HPV recommendations, i.e., vaccination at age 11 or 12 years, with vaccine use recommended through age 26 for females and through age 21 for males, as well as through age 26 for men who are immunocompromised and men who have sex with men. For females, the 2-valent (Cervarix®, GSK), 4-valent (Gardasil®, Merck), or 9-valent (Gardasil 9, Merck) HPV vaccine may be used, while males should receive either 4-valent or 9-valent HPV vaccine. The 9vHPV vaccine is not yet approved by the FDA for males age 16 through 26 years, so use in this age group is off-label but is ACIP-recommended.

The addition of 9vHPV vaccine to the options of vaccines that may be used to prevent HPV infection had no impact on the recommended vaccine intervals or contraindications for use in pregnant women.

Any HPV vaccine, including 9vHPV, may be used to complete a previously begun HPV vaccine series. ACIP did not address the use of 9vHPV vaccine for persons who have previously completed a full HPV vaccine series.

Updated ACIP HPV recommendations were published on March 27, in MMWR and are available online

In PDF format on pages 300-304.

In HTML format

Yellow fever vaccine

ACIP voted to recommend that a single dose of yellow fever (YF) vaccine (YF-VAX®, Sanofi) provides long-lasting protection and is adequate for most travelers. ACIP also stated that additional doses of YF vaccine may be indicated for certain populations as follows:

Women who were pregnant when they received their initial dose of YF vaccine should receive one additional dose prior to their next travel that puts them at risk for yellow fever virus infection.
Individuals who received a hematopoietic stem cell transplant after receiving a dose of yellow fever vaccine and who are sufficiently immunocompetent to be safely vaccinated should be revaccinated prior to their next travel that puts them at risk for yellow fever virus infection.
Individuals who were HIV-infected when they received their last dose of YF vaccine should receive a dose every 10 years if they continue to be at risk for yellow fever infection.

Finally, a booster dose of YF vaccine may be considered for travelers who received their last dose of YF vaccine at least 10 years previously and who will be in a higher-risk setting based on season, location, activities and duration of their travel. This would include travelers who plan to spend a prolonged period of time in endemic areas or those traveling to highly endemic areas such as rural West Africa during peak transmission season or areas with ongoing outbreaks.

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