ATLANTA Healthy children between 2 and 5 years of age who have been incompletely vaccinated against pneumococcal disease should receive one dose of 7-valent pneumococcal conjugate vaccine, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices voted at its fall meeting.
The panel also voted that children aged 24-59 months with underlying medical conditions who are incompletely vaccinated should receive two doses of 7-valent pneumococcal conjugate vaccine (PCV7) at least 2 months apart, unless they have already received three doses, in which case one dose should be given.
The definition of underlying conditions includes sickle-cell disease or related conditions, splenic dysfunction, HIV infection, immunocompromising conditions, chronic cardiac or pulmonary disease, cerebrospinal fluid leaks, and diabetes mellitus (MMWR 2000;49[RR-9]:1-38).
"The Work Group feels that simplifying and expanding the catch-up recommendation may improve PCV7 coverage among healthy, unvaccinated or incompletely vaccinated children aged 24-59 months, including immigrants and adoptees," said Dr. Pekka Nuorti of the CDC.
The catch-up recommendations could apply to a significant proportion of children, given that 32% of children aged 2-5 years have received fewer than four doses of PCV7, according to 2006 National Immunization Survey data. However, the majority of children (87%) have received at least three doses of the vaccine.
The ACIP vote passed 11-3, with panel members raising several concerns. Some questioned the extent of disease prevention that the change would provide and the cost-effectiveness of the recommendation. No formal cost-effectiveness analysis has been done, and panel members explained that the aim was just to clarify the existing recommendations. ACIP plans to revise its statement on pneumococcal diseases this year.