The Advisory Committee on Immunization Practices (ACIP) from the Centers of Disease Control and Prevention (CDC) has issued its recommended immunization schedule for children and adolescents aged ≤18 years in the US. Changes include new or revised recommendations for poliovirus, influenza, and measles, mumps, and rubella vaccines, and clarification of the recommendation for rotavirus and pneumococcal vaccines. Simplified figures and footnotes are also part of the new immunization schedule. Some of the key figure changes include:
- The maximum ages for the first and last doses in the rotavirus vaccination series were added to the rotavirus vaccine row.
- The inactivated poliovirus vaccine rows were edited to clarify the catch-up recommendations for children aged ≥4 years.
- A reference for use of live vaccines in patients with HIV was added.
The full updated 2018 ACIP immunization schedule can be found at https://www.cdc.gov/mmwr/volumes/67/wr/mm6705e2.htm?s_cid=mm6705e2_e.
Robinson CL, Romero JR, Kempe A, Pellegrini C, Szilagyi P. Advisory Committee on Immunization Practices Recommended Immunization schedule for children and adolescents aged 18 years or younger—United States, 2018. MMWR Morb Mortal Wkly Rep 2018;67:156–157. doi:10.15585/mmwr.mm6705e.
The updated ACIP immunization schedule is always worth looking at. Judging from questions we receive in the office, there are areas of confusion based on changes over the last few years with the HPV and the meningitis vaccines. To clarify those areas:
- ACIP recommends routine HPV vaccination at age 11 or 12 years. For persons initiating vaccination before their 15th birthday, the recommended immunization schedule is 2 doses of HPV vaccine. The second dose should be administered 6–12 months after the first dose. For persons initiating vaccination on or after their 15th birthday, the recommended immunization schedule is 3 doses of HPV vaccine. The second dose should be administered 1–2 months after the first dose, and the third dose should be administered 6 months after the first dose.
- ACIP recommends routine administration of a MenACWY vaccine for all persons aged 11 through 18 years. A single dose of vaccine should be administered at age 11 or 12 years, and a booster dose should be administered at age 16 years. Adolescents who receive their first dose at age 13 through 15 years should receive a booster dose at age 16 through 18 years.
- The ACIP currently recommends routine use of MenB vaccines [Bexsero, Trumenba] among persons aged ≥10 years who are at increased risk for serogroup B meningococcal disease. Men B may be given at clinical discretion to adolescents 16–23 years (preferred age 16–18 years) who are not at increased risk according to the following schedule: Bexsero: 2 doses at least 1 month apart; Trumenba: 2 doses at least 6 months apart. —Neil Skolnik, MD
Must Reads in Pediatrics
Firearms Mortality Among US Schoolchildren, Am J Med; ePub 2019 Mar 25; Rubenstein, et al
AHA Statement: CV Risk Reduction in Pediatrics, Circulation; ePub 2019 Feb 25; de Ferranti, et al
Epicutaneous Immunotherapy in Peanut Allergy, JAMA; ePub 2019 Feb 22; Fleischer, et al