The Advisory Committee on Immunization Practices (ACIP) has unanimously approved a series of changes to the adult immunization schedule for several vaccines.
The changes, which must next be approved by the director of the Centers for Disease Control and Prevention, will take effect in 2016. The biggest shifts are related to meningococcal B vaccinations, which are now listed separately in the schedule from vaccination recommendations for all other meningococcal strains.
Adults with asplenia “or complement deficiencies,” microbiologists, and those who routinely work in outbreak settings are recommended to get either a two-dose series of MenB-4C (Bexsero) or a three-dose series of MenB-FHbp (Trumenba) in the 2016 guidelines, according to Dr. David Kim of the CDC’s National Center for Immunization and Respiratory Diseases, who presented the changes at a meeting of the CDC’s ACIP on Oct. 21. The same vaccine type should be taken through an immunization series, as these are not interchangeable.
However, vaccination is not recommended for individuals who travel or live in countries where meningococcal disease is hyperendemic or epidemic, as the disease in these countries is generally not known to be caused by serogroup B. Also, young adults aged 16-23 years maybe receive the vaccine to provide short-term protection against most strains of MenB disease; however, it is mostly recommended for individuals aged 16-18 years. The recommendation for young adults is a Category B recommendation, which means it has not yet been fully integrated into the 2016 schedule and will be listed in the footnotes of the schedule.
For the human papillomavirus vaccine, all women aged 19-26 years are recommended to receive a three-dose series of either 2-valent, 4-valent, or 9-valent HPV vaccine unless they have been vaccinated previously or did not complete the previous series. Men aged 19-21 years should also get a three-dose series of either 4-valent or 9-valent HPV vaccine, according to the recommendations. Homosexual and immunocompromised men, including those with HIV infections, should receive a three-dose series of either 4-valent or 9-valent HPV vaccines through age 26.
Updates were also approved for pneumococcal virus vaccinations, as there are now changes in intervals for PCV13 and PPSV23. Immunocompetent adults 65 years and older should receive PPSV23 at least 1 year after PCV13, not 6-12 months afterward as recommended under the 2015 schedule.