Vaccine updates: Meningococcal vaccines, flu, immunization schedules

Recent guidance from the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices, reported by AOA liaison Stanley E. Grogg, DO, covers this season’s flu vaccine, an overview of meningococcal vaccines in the U.S., and a look at what updates will be included in the 2016 Child and Adolescent and Adult Immunization Schedule.

Flu vaccine

The 2015-16 seasonal flu vaccine has a new A and B serotype and is different from last season’s vaccine. So far, the few cases of influenza reported this year in the U.S. have included the new serotypes in the immunization.

Meningococcal vaccine overview

The meeting included an update on meningococcal vaccines in the U.S.:

• To protect against meningococcal A,C, W, and Y strains, polysaccharide MPSV4 (Menomune by Sanofi) can be used; it’s indicated for patients 2 years old and older. Conjugated vaccine MCV4 can also be used; examples include Menactra MCV A, C, W, Y-D by Sanofi, which is indicated for patients 9 months to 25 years of age, and Menveo MCV A, C, W, Y-CRM by GSK, for patients 2 months to 55 years of age.
• To protect against meningococcal C and Y strains, MenHibrix by GSK can be used for patients 6 weeks to 18 months of age.
• To protect against meningococcal B strains, physicians can use Trumenba by Pfizer, which is for patients 10 to 25 years old and includes three dose services, or Bexsero by GSK, which has two dose services and is also for patients 10 to 25 years old.

Note that routine vaccination against meningococcal disease is not recommended for children aged 2 months through 10 years; it’s recommended only for high-risk infants.

2016 child and adult immunization schedules

The 2016 Child and Adolescent and Adult Immunization Schedules were approved and will be published toward the end of January 2016. The most noteworthy changes in the child and adolescent schedule will be minor alterations in the footnotes and the above update on meningococcal vaccines. Updates to the adult immunization schedule include:

• Additional information on females aged 19-26 years concerning 2vHPV, 4vHPV, or 9vHPV vaccinations.
• For males 19 to 21 years old, a three-dose series of 4vHPV or 9vHPV is recommended.
• For pneumococcal vaccines, the interval between PCV13 (Prevnar 13 by Pfizer) and PPSV23 (Pneumovax by Merck) for adults aged 65 or older is more than 1 year.
• For adults aged 19 to 64 years with immunocompromising conditions for whom pneumococcal vaccines are recommended, the PCV13 should be given first and should be separated from PPSV23 by eight weeks.
• A hepatitis B series will be added for persons with end-stage renal disease.