Education & Training:

Epidemiology & Prevention of Vaccine-Preventable Diseases 2008: Updates & Clarifications

Zoster

• ACIP published "Prevention of Herpes Zoster." (6/6/08)
  

Tdap

• ACIP published "Prevention of Pertussis, Tetanus, and Diphtheria Among Pregnant and Postpartum Women and Their Infants." (5/30/08)
  

Human Papillomavirus Vaccine (HPV)

• On March 5, 2008 a revised child and adolescent immunization catch-up schedule was published that added a 24 week interval between HPV doses 1 and 3. This recommendation was added because of the paucity of data for females who received HPV vaccine on a 0-1-4 month schedule during the clinical trials. A revised schedule can be obtained at www.cdc.gov/vaccines/recs/schedules/child-schedule.htm#printable.
  
  If the 3-dose HPV series was administered in less than 24 weeks, but in at least 16 weeks, it is not necessary to repeat the third dose, if at least 4 weeks separated doses 1 and 2, and at least 12 weeks separated doses 2 and 3. However, if the 3-dose series was administered in less than 16 weeks the third dose should be repeated at least 12 weeks after the invalid dose. (5/5/08)

 

Combination MMRV (ProQuad®)

• Fever is more common in the 5-12 days after vaccination following MMRV (22%) than following MMR and varicella administered as separate vaccines (15%). Data from CDC Vaccine Safety Datalink sites indicate the rate of febrile seizures following MMRV (9 per 10,000 vaccinated ) was approximately 2 times higher than among those receiving MMR and varicella separately at the same visit (4 per 10,000 vaccinated). Based on these estimates, during the 7-10 days after vaccination about one additional febrile seizure would be expected to occur for every 2,000 children who receive MMRV vaccine rather than separate MMR and varicella vaccines.
  
  After considering these data, ACIP revised its recommendation on the use of MMRV. ACIP recommends that there is no preference for use of MMRV vaccine over separate administration of MMR and varicella vaccines. Providers can choose whether to administer MMRV or MMR and varicella vaccines separately. This recommendation was published in MMWR on March 14, 2008. See www.cdc.gov/mmwr/preview/mmwrhtml/mm5710a3.htm for details. (5/5/08)

 

Influenza vaccine

• At its February 2008 meeting, ACIP voted to extend the age for routine annual influenza vaccination through age 18 years beginning in the 2008-2009 season. These provisional recommendations were posted to the ACIP website on March 25, 2008 and will be published in the annual influenza ACIP statement later in 2008. See www.cdc.gov/vaccines/recs/provisional/downloads/flu-3-21-08-508.pdf for details. (5/5/08)

• Information about the composition of the 2008-2009 U.S. influenza vaccine was published in MMWR on April 18, 2008. All three strains will be changed for the 2008-2009 season. See www.cdc.gov/mmwr/preview/mmwrhtml/mm5715a4.htm for details. (5/5/08)

 

Pneumococcal conjugate vaccine (PCV)

• On April 4, 2008, ACIP published revised recommendations for the use of PCV among children 24 through 59 months of age. These recommendations update the original recommendations for this age group published in 2000. ACIP now recommends one dose of PCV for all healthy children 24 through 59 months who have not completed any recommended schedule for PCV. See www.cdc.gov/mmwr/preview/mmwrhtml/mm5713a4.htm for details. (5/5/08)

 

Measles outbreaks in the United States

• CDC published updated information about the ongoing outbreaks of measles in several states in the May 1, 2008 issue of MMWR. This report is available at www.cdc.gov/mmwr/preview/mmwrhtml/mm57e501a1.htm. The majority of measles cases were imported or linked to imported cases, and most persons with measles were either younger than 12 months of age (too young for routine vaccination) or unvaccinated because of personal beliefs. (5/5/08)

 

Syncope following vaccination

• Since 2005, an increased number of reports of syncope have been received by the Vaccine Adverse Event Reporting System. Most of the increase has been contributed by females 11-18 years of age. Serious injuries have occurred, including one fatality from intracranial hemorrhage caused by head trauma. The Food and Drug Administration and the CDC Immunization Safety Office published a summary of these findings in the May 2 issue of MMWR, which can be obtained at www.cdc.gov/mmwr/preview/mmwrhtml/mm5717a2.htm. Among persons for whom time of vaccination and syncope were reported, 52% of syncopal episodes occurred within 5 minutes of vaccination and 70% occurred within 15 minutes. Vaccine providers should strongly consider observing persons for 15 minutes after they are vaccinated, particularly adolescents and young adults. If syncope develops patients should be observed until symptoms resolve. (5/5/08)

 

Meningococcal conjugate vaccine (MCV)

• At its February 2008 meeting ACIP discussed the possibility of routine meningococcal vaccine for all children 2 through 10 years of age. Based on current epidemiology of meningococcal disease, an analysis of the cost-effectiveness of such a strategy, and programmatic considerations, ACIP decided NOT to recommend routine meningococcal vaccination for this age group at this time. Meningococcal vaccination continues to be recommended for children at increased risk for meningococcal diseases (such as travelers to endemic areas and children with functional or anatomic asplenia). See www.cdc.gov/mmwr/preview/mmwrhtml/mm5717a4.htm for details. (5/5/08)

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