Immunization practices

CDC advisory committee updates rabies vaccine recommendations

The committee recommends a two-dose rabies vaccine and pre-exposure prophylaxis for at-risk individuals and also discusses zoster, flu, cholera and orthopoxviruses vaccines.

In its meeting last week, the CDC’s Advisory Committee on Immunization Practices (ACIP) recommended a rabies vaccine and rabies vaccine booster shots for certain individuals. Stanley Grogg, DO, the AOA’s liaison to ACIP, shared the highlights of the meeting with the AOA. At the meeting, officials also discussed other vaccines. Following is a summary of Dr. Grogg’s report.

Rabies vaccine

ACIP now recommends a two-dose intramuscular rabies vaccine series as pre-exposure prophylaxis (PrEP) for immunocompetent adults who are at moderate risk of contracting rabies. This includes diagnostic lab professionals, bat biologists, animal care professionals, students, spelunkers and persistent travelers.

ACIP is also now recommending rabies vaccine booster shots for individuals who have an elevated risk for rabies exposure—animal care professionals, students, spelunkers and persistent travelers. These populations should receive a vaccine booster no later than three years after their last rabies vaccine. Alternatively, they can get a titer check to assess their immunity.

For those at lower risk of contracting rabies, such as diagnostic lab professionals and bat biologists, ACIP recommends a titer check every six months.

Zoster vaccine

The committee noted that over 41 million doses have been distributed from the vaccine’s launch to the end of 2020 and that no change to the current zoster vaccine recommendation is needed at this time.

Influenza vaccine

The current (2020-2021) flu season saw the highest ever number of flu vaccines administered as well as a very low incidence of flu and just one pediatric death. Due to flu’s low incidence, the effectiveness of this year’s vaccine is unknown.

Cholera vaccine

In 2016, ACIP recommended Vaxchora, a cholera vaccine, for adult travelers 64 years old and younger. In December 2020, the FDA approved Vaxchora for children ages 2-17 years. ACIP is currently assessing whether to recommend Vaxchora for children.

Orthopoxviruses vaccines

ACIP expects to vote on whether to recommend two FDA-approved vaccines for orthopoxviruses in October 2021: ACAM2000 for smallpox and Jynneos for smallpox and monkeypox. Monkeypox cases are increasing in central and eastern Africa. Those at risk for smallpox infection include researchers and laboratory personnel who study or test for smallpox.

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