This transcript has been edited for clarity.
Hello. I am Dr. Sandra Freihofer. Welcome to WordPress.Topics are highlights from ACIP’s 2023 New Adult Schedule, It was published in the Annals of Internal Medicine, And why this new schedule is a collector’s item.
New year. This means the new ACIP Adult Immunization Schedule. This is a valuable resource for collating ACIP’s latest immunization recommendations.
Here are the five most significant changes this year:
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COVID vaccines are now at the forefront and center
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New focus on polio immunization
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Inclusion of some non-vaccine products (such as monoclonal antibody products)
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Pharmacist Association Approves Schedule for the First Time
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A new shared clinical decision-making option for pneumococcal vaccines
The organization of the schedule remains unchanged. There are still 4 sections.
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Table 1: Immunizations by Age
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Table 2: Immunizations by medical condition and other indications
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NOTE SECTION (ALPHABETICALLY BY VACCINE TYPE)
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Appendix List of Contraindications and Precautions by Vaccine
However, what is unique this year is that some of the abbreviations have historical significance. The first change isn’t a big surprise given what we’ve been through in the last few years. COVID vaccines are listed first on the cover page by brand name for those approved and by company name for those with U.S. Emergency Use Authorization. increase.
COVID and mRNA and protein-based vaccines have been assigned official abbreviations based on vaccine platform and valency.
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1vCOV-mRNA: Comirnaty/Pfizer-BioNTech and Spikevax Moderna COVID-19 vaccine
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2vCOV-mRNA: a bivalent COVID-19 vaccine from Pfizer-BioNTech and Moderna
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1vCOV-aPS: Novavax COVID-19 vaccine
It is also worth noting that the list does not include a COVID viral vector vaccine. However, the viral vector COVID vaccine (available but not recommended) has a link to his website for the CDC in the notes section.
A sad but necessary inclusion was sparked by a recent polio case in New York. In the new schedule, polio vaccine is listed on the cover page but not included in the table. Current polio vaccination recommendations are provided in the Notes section.
Also of historical importance and potential precedent is the inclusion of non-vaccine products.The value of COVID pre-exposure prophylaxis with products containing monoclonal antibodies (e.g. Evusheld) for people with moderate or severe disease Immunodeficiency I list it in the remarks column.
This schedule is the first to be approved by the American Pharmacists Association, which validates pharmacists as established partners in vaccine administration.
color code key
One aspect of the schedule that has not changed is the color code key.
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Yellow: recommended if patient meets age requirements
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Purple: indicated for people with additional risk factors or another indication
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Blue: recommendations based on shared clinical decisions
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Orange: Caution
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Red: contraindicated or not recommended. Vaccines should not be given. The red overlay more accurately clarifies whether the vaccine is truly contraindicated or simply not recommended. A red asterisk means vaccination after pregnancy, if indicated.
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Gray: Not Recommended or Not Applicable
Immunizations by age
Table 1 shows recommended vaccinations by age. There is one big change. The COVID vaccine is in the first row of the graphic, with overlays highlighting the need for both primary series and boosters. The note has a hyperlink to his latest COVID vaccination recommendations.
Highlights from Table 1:
Pneumococcal vaccination. Pneumococcal vaccination is recommended starting at age 65 on a regular basis. Current recommendations for previously unvaccinated persons have not changed since last year. However, in Table 1, the bottom half of the 65+ rows are blue (this is new). This new color, blue, signifies shared clinical decision-making and applies to people who were previously considered fully vaccinated with a combination of He PCV13 and He PPSV23. These patients were given the option of administering her PCV20 five years after he completed the PCV13-PPSV23 combo series. This option is blue because the decision is up to you and your patient.
For more information on pneumococcal vaccination, please review the Precautions. For example, if he was partially vaccinated using a lower valency vaccine, he has the option of replacing PPSV23 with his PCV20 to broaden and improve the durability of protection.
The recommended options for pneumococcal vaccine are complex.new Pneumococcal vaccination app can help.
Hepatitis B. For adults under the age of 60, Hepatitis B vaccine is yellow, meaning it is shown in all. For older patients, the color code is purple. If a patient over 60 wishes hepatitis B vaccines can be given without additional risk indications.
Immunization due to medical conditions or other indications
Other than a few minor word changes on the overlay, the only new line is the COVID vaccine.
This table provides vaccine recommendations for pregnancy, immunodeficiency, HIV (with details by CD4 count), Asplenia, compensate for deficiencyheart disease, lung disease, alcoholismchronic liver disease, diabetes, health care workers, and men who have sex with men.
For vaccination recommendations, use this table to dot the i and cross the t. Take the pregnancy column, for example. LAIV, MMR, and Chickenpox, are contraindicated and are color-coded in red. MMR and chickenpox are also marked with an asterisk, meaning that they should be vaccinated after pregnancy if necessary. The HPV vaccine is not a live virus vaccine, but the overlay says it is not recommended during pregnancy. An asterisk indicates that the vaccine can be given after pregnancy.
Vaccine Precautions
The notes are arranged alphabetically and their organization (routine, special circumstances, and sharing of clinical decisions where indicated) has not changed. They are brief and concise, but sometimes not enough. That’s why vaccine-specific links to more complete recommendations are so useful.
Hepatitis B precautions include nuances regarding specific dosages for vaccinating patients undergoing dialysis. Hepatitis C Vaccines such as Heplisav and PreHevbrio are not recommended during pregnancy due to lack of safety data.
for influenza, everyone 6 months and older should have annual flu vaccination with the flu vaccine appropriate for their age and health status. , that is, high-dose, recombinant, or adjuvanted versions. However, if these are not available, getting the flu vaccine is better than not getting it.
The meningococcal vaccine combines the MenACWY and MenB notes. For MenB, the trade names Bexsero and Trumenba are given due to product incompatibility. The booster interval for people still at risk varies for each vaccine type. Every 5 years for the MenACWY booster and every 2-3 years for the MenB booster.
The recent polio cases in New York put polio vaccination in the spotlight. ACIP is now reviving the Polio Vaccine Working Group. The new schedule has the polio vaccine on the cover. Added current recommendations to notes section. Routine immunizations for adults are not required, at least not for now. However, people at high risk of exposure to polio fall into the special circumstances category. A high-risk person who has completed a polio vaccine course can have her dose of a lifetime IPV booster. For those at high risk who have not completed the polio vaccine series, now is the time to end the series.
appendix
The final step in using the new schedule is to review the appendix and its list of vaccine-specific contraindications and precautions.
We hope you find this review of the new ACIP adult immunization schedule helpful. For medical matters, I’m Dr. Sandra Freihofer.
