Schedule Changes & Guidance

• Added 20- valent pneumococcal conjugate vaccine (PCV20), Mpox vaccine (Jynneos), RSV monoclonal antibody (nirsevimab), RSV vaccine (Abrysvo), and meningococcal groups A, B, C, W, Y (Penbraya).
• Deleted bivalent mRNA COVID-19 vaccines, diphtheria and tetanus Toxoid Adsorbed vaccine (DT), 13-valent pneumococcal conjugate vaccine (PCV13), and meningococcal groups A, C, W, Y polysaccharide diphtheria toxoid conjugate vaccine (MenACWY-D, Menactra)
• Added RSV and Mpox to the list of vaccines excluded from the vaccine injury compensation program (VICP)
• Added Mpox vaccine to the list of vaccines covered by the Countermeasures Injury Compensation Program (CICP)
• Added a new Addendum section to summarize new and updated ACIP recommendation that will occur after the 2024 child and adolescent immunization schedule is published.

The COVID-19 note was revised to provide guidance for use of updated (2023–2024 Formula) COVID-19 vaccines.

The DTaP note was revised to clarify primary and booster doses

The routine vaccination section was revised to clarify additional doses are not recommended for persons who have completed HPV vaccination series with any valency using the recommended dosing intervals.

The influenza note was updated to reflect the recommendations for the 2023-24 influenza season. In the “Special situations” section, all bullets describing recommendations for persons with a history of egg allergy have been deleted. A note has been added clarifying persons with a history of egg allergy of any severity can be vaccinated with any influenza vaccine indicated for the recipient’s age and health status with no additional safety considerations.

The MMR note was updated to clarify when MMRV is used for routine, catch-up vaccination, or in “Special situations”, the minimum interval between doses is 3 months.

MenACWY-D (Menactra) has been removed from all sections. Information on recommendation for the use of the newly licensed meningococcal A, B, C, W, Y vaccine have also been included.

Information about the use of the newly licensed meningococcal A, B, C, W, Y vaccine has been added. A resource to assist healthcare providers with shared clinical decision-making recommendations for MenB vaccination has also been included.

An Mpox note was added to provide guidance for use of Jynneos in adolescents age 18 years based on sexual risk factors.

PCV13 has been deleted from all sections. The routine vaccination, catch-up vaccination, and “Special situations” sections have been updated with the new recommendations for use of 15-valent pneumococcal conjugate vaccine (PCV15), PCV20, and PPSV23. Chronic kidney disease, chronic liver disease, and moderate persistent or severe persistent asthma were added to the list of medical conditions that increase the risk for invasive pneumococcal disease.

The “Catch up” vaccination has been revised to include updated recommendations for adolescents age 18 years. The recommendations for adolescents age 18 years who are at increased risk for exposure to poliovirus and have completed the primary series have also added.

A note was added to provide details on the use of nirsevimab in infants and young children. Additionally, information describing timing of immunization including guidance for jurisdictions with RSV seasonality that differs from most of the continental United States was added.

A note was added to provide details on the use of RSV vaccine during pregnancy. Abrysvo is the only RSV recommended for use during pregnancy. Information describing timing of vaccination including guidance for jurisdictions with RSV seasonality that differs from most of the continental United States has also been included.

The Tdap note was revised to clarify that the Tdap dose recommended at age 11–12years is the adolescent Tdap booster dose.

COVID-19 row: added new rows describing the contraindications and precautions to mRNA and protein subunit COVID-19 vaccination

DTaP and DT row: deleted DT because this vaccine is no longer distributed in the United States.

Hib row: removed history of severe allergic reaction to dry natural latex from the “Contraindicated or Not Recommended” column

Meningococcal ACWY row: Menactra has been removed because this product is no longer distributed in the United States.

Meningococcal ABCWY row: added a new row describing the contraindications and precautions to MenABCWY vaccination

RSV-mAb (nirsevimab) row: added a new row describing the contraindications and precautions to nirsevimab immunization.

RSV row: added a new row describing the contraindications and precautions to RSV vaccination

• Added Mpox vaccine (Jynneos), RSV vaccines (Abrysvo and Arexvy), and meningococcal groups A, B, C, W, Y (Penbraya)
• Deleted bivalent mRNA COVID-19 vaccines and meningococcal groups A, C, W, Y polysaccharide diphtheria toxoid conjugate vaccine (MenACWY-D, Menactra)
• Added RSV and Mpox to the list of vaccines excluded from the vaccine injury compensation program (VICP)
• Added Mpox vaccine to the list of vaccines covered by the Countermeasures Injury Compensation Program (CICP)
• Added a new Addendum section to summarize new and updated ACIP recommendations occurring after the 2024 adult immunization schedule is published.

The COVID-19 note was revised to provide guidance for use of updated (2023–2024 Formula) COVID-19 vaccines.

The note was revised to clarify that any person who is not fully vaccinated and requests vaccination can receive HepA.

The note was updated to describe the risk-based vaccination recommendation for persons 60 years of age and older. Information on the shared clinical decision-making recommendation for persons 60 years of age and older with diabetes has also been added.

The routine vaccination section was revised to clarify additional doses are not recommended for persons who have completed HPV vaccination series with any valency using the recommended dosing intervals. Additionally, a hyperlink to a resource describing shared clinical decision-making recommendations for HPV vaccination was provided to assist healthcare providers.

The influenza note was updated to reflect the recommendations for the 2023-24 influenza season. In the “Special situations” section, all bullets describing recommendations for persons with a history of egg allergy have been deleted. A note has been added clarifying persons with a history of egg allergy of any severity can be vaccinated with any influenza vaccine indicated for the recipient’s age and health status with no additional safety considerations.

MenACWY-D (Menactra) has been removed from all sections. Information on recommendation for the use of the newly licensed meningococcal A, B, C, W, Y vaccine and a resource to assist healthcare providers with shared clinical decision-making recommendations for MenB vaccination have also been included.

An Mpox note was added to provide guidance for use of Jynneos in adolescents age 18 years based on sexual risk factors.

The routine vaccination and “Special situations” sections were revised to provide clarity on the guidance and minimum intervals between pneumococcal vaccine doses.

The poliovirus vaccination note was updated to add the routine recommendations for adults who are known or suspected to be unvaccinated or incompletely vaccinated to complete the 3-dose IPV primary series. The recommendation for adults who are at increased risk for exposure to poliovirus and have completed the primary series was also added.

Details were provided on the use of RSV vaccine during pregnancy and in adults 60 years of age and older. Information describing timing of vaccination including guidance for jurisdictions with RSV seasonality that differs from most of the continental United States has also been included. Another note was added that lists the risk factors and medical conditions that healthcare providers should consider when thinking about a patient’s risk for severe RSV disease and if such patients would benefit from vaccination. Finally, a hyperlink to a resource describing shared clinical decision-making recommendations for RSV vaccination among patients 60 years of age and older was provided.

The Tdap note was revised to clarify that a dose of Tdap received at 10 years of age may be counted as the adolescent dose that is routinely recommended at age 11-12 years.

COVID-19 row: added new rows describing the contraindications and precautions to mRNA and protein subunit COVID-19 vaccination