Immunization Updates: Yellow Fever, Meningococcal Disease, HPV

The yellow fever booster vaccine is no longer recommended for most travelers, routine HPV vaccination should occur at age 11 or 12, and high-risk child and adolescent patients should receive the meningococcal vaccine. These are among the latest recommendations from the CDC Advisory Committee on Immunization Practices, reported by AOA liaison Stanley E. Grogg, DO. Here’s a roundup of new developments from the ACIP:

Child/adolescent vaccine schedule update

• The child/adolescent vaccine schedule was modified to include the addition of the meningococcal vaccine for high-risk patients.
• The ACIP also approved immunization recommendations for the adult and catch-up vaccine schedules, but most changes were minor.

Meningococcal vaccines

• Two new meningococcal B conjugated vaccines were recently approved by the FDA, Bexsero by Novartis and Trumenba by Pfizer.
• The ACIP recommends that a serogroup B meningococcal (MENB) vaccine series be administered to persons aged 10 or older at increased risk for meningococcal disease. High-risk persons included those with persistent complement component deficiencies, with anatomic or functional asplenia, missiologists routinely exposed to isolates of N. meningitides and persons identified to be at increased risk because of a serogroup B meningococcal disease outbreak.

Influenza and HPV vaccines

• The primary serotype for the 2014-15 influenza seasons was H3N2. Because of viral drifting, the injectable influenza vaccine (IIV) was overall only 31% effective and the live attenuated influenza vaccine (LAIV) was 19% effective. The lower efficacy of the LAIV was felt to be related to the transport system being utilized. MedImmune is in the process of correcting this problem.
• The ACIP recommendation for healthy children aged 2 through 8 years who have no contraindication or precautions, can be given either LAIV or IIV.
• No preferences are expressed for LAIV or IIV of high-risk types of HPV. After review of evidence-based studies, the ACIP recommended routine HPV vaccination at age 11-12 years and for females aged 13 through 26 years.
• In addition, for males aged 13-26 years who have not been vaccinated previously or who have not completed the three-dose series, MENB was recommended.

Yellow fever vaccine

• The yellow fever vaccine had previously been recommended as a two-dose series which included a booster dose 10 years after the initial dose.
• After reviewing the literature, the ACIP found that a single dose of yellow fever vaccine provides long-lasting protection for most travelers.