Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine Among Adults Aged ≥65 Years: Updated Recommendations of the Advisory Committee on Immunization Practices

Two pneumococcal vaccines are currently licensed for use in adults in the United States: a 13-valent pneumococcal conjugate vaccine (PCV13 [Prevnar 13, Pfizer, Inc.]) and a 23-valent pneumococcal polysaccharide vaccine (PPSV23 [Pneumovax 23, Merck and Co., Inc.]). In 2014, the Advisory Committee on Immunization Practices (ACIP)* recommended routine use of PCV13 in series with PPSV23 for all adults aged ≥65 years based on demonstrated PCV13 safety and efficacy against PCV13-type pneumonia among adults aged ≥65 years (1). At that time, ACIP recognized that there would be a need to reevaluate this recommendation because it was anticipated that PCV13 use in children would continue to reduce disease burden among adults through reduced carriage and transmission of vaccine serotypes from vaccinated children (i.e., PCV13 indirect effects). On June 26, 2019, after having reviewed the evidence accrued during the preceding 3 years (https://www.cdc.gov/vaccines/acip/recs/grade/PCV13.html), ACIP voted to remove the recommendation for routine PCV13 use among adults aged ≥65 years and to recommend administration of PCV13 based on shared clinical decision-making for adults aged ≥65 years who do not have an immunocompromising condition,† cerebrospinal fluid (CSF) leak, or cochlear implant, and who have not previously received PCV13. ACIP recognized that some adults aged ≥65 years are potentially at increased risk for exposure to PCV13 serotypes, such as persons residing in nursing homes or other long-term care facilities and persons residing in settings with low pediatric PCV13 uptake or traveling to settings with no pediatric PCV13 program, and might attain higher than average benefit from PCV13 vaccination. When patients and vaccine providers§ engage in shared clinical decision-making for PCV13 use to determine whether PCV13 is right for a particular person, considerations might include both the person's risk for exposure to PCV13 serotypes and their risk for developing pneumococcal disease as a result of underlying medical conditions. All adults aged ≥65 years should continue to receive 1 dose of PPSV23. If the decision is made to administer PCV13, it should be given at least 1 year before PPSV23. ACIP continues to recommend PCV13 in series with PPSV23 for adults aged ≥19 years with an immunocompromising condition, CSF leak, or cochlear implant (2).

Author/s:

Matanock, A, Lee, G, Gierke, R, Kobayashi, M, Leidner, A, Pilishvili, T

ACIP Approves New Guidance on HPV, Pneumococcal Vaccines

Brian Desmarais — Wed, 10 Jul 2019 00:22:03 +0000

Date Added:

July 9, 2019

Journal/Publication:

American Academy of Family Physicians

Publication Date:

July 3, 2019

URL:

ACIP Approves New Guidance on HPV, Pneumococcal Vaccines

Type:

Public Health Announcements

Format:

Web Page

Keywords

MeSH

Neisseria meningitidis, Serogroup B

Pneumococcal Vaccines

centers for disease control and prevention (U.S.)

The Advisory Committee on Immunization Practices have updated their recommendations regarding HPV vaccine in adults 27-45 (shared decision-making), PCV 13 vaccine in adults 65 and older (shared decision-making), and Meningococcal B vaccine (booster dose after 1 – 2 years in immunocompromised children).

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July 03, 2019 03:21 pm Chris Crawford – During the June 26-27 meeting(www.cdc.gov) of the CDC's Advisory Committee on Immunization Practices, the group voted to update its recommendations for use of the nine-valent HPV and 13-valent pneumococcal conjugate vaccines.

AAFP liaison to the ACIP Pamela Rockwell, D.O., of Ann Arbor, Mich., told AAFP Newsother topics considered during the meeting included recommendations for a catch-up schedule for children and adolescents ages 2-18 who hadn't previously received hepatitis A vaccine, as well as guidance for serogroup B meningococcal vaccination boosters for those with special conditions/circumstances.

Author/s:

Crawford, C.