ACIP recommends enhanced flu vaccines for older Americans, adds MMR vaccine
The CDC’s Advisory Committee on Immunization Practices voted unanimously on Wednesday to recommend enhanced influenza vaccines for older Americans, introduce a second MMR vaccine, and OK a 15-valent pneumococcal vaccine for children.
The committee voted 15-0 to recommend that people aged 65 years or older receive a high-dose inactivated influenza vaccine, adjuvanted inactivated influenza vaccine, or recombinant influenza vaccine over any of the standard-dose unadjuvanted, inactivated vaccines.
They assessed preliminary data from the 2021–2022 influenza season, which showed that vaccination reduced acute respiratory illness from influenza A(H3N2) by 35% (95% CI, 19%47%). But Lisa Grohskopf, MD, MPH, of the CDC’s Influenza Division, noted that influenza vaccines are often less effective among older populations, leading to the need for specific recommendations for high-dose vaccines in this population.
To address this concern, experts looked at data shared from the influenza work group’s recent systematic review of influenza vaccines for persons aged 65 years or older. They found that the vaccines were effective, safe and accepted among older adults.
“I am super excited today that we are approving these vaccines in older adults. Really the prevention of hospitalization and reducing the time of disability is incredibly important for our seniors, [who are] a growing population,” Helen Keipp Talbot, MD, MPH, associate professor of medicine at Vanderbilt University, said during the meeting.
“Along those lines though, I’d like to add that these influenza vaccines are better, but they are not the home run we would love to have,” Talbot said. “[We need to] continue to try for the holy grail of an influenza vaccine that will work every time and for our older patients.”
The committee also voted unanimously to recommend Vaxneuvance (PCV15) for children. Merck’s 15-valent pneumococcal vaccine was approved by the FDA for infants and children aged 6 weeks to 17 years earlier in the day.
The unanimous vote came after Merck shared trial data assessing the safety, tolerability and immunogenicity of the vaccine among infants, children and adolescents. According to the data, immune responses elicited by PCV15 following a four-dose pediatric series were noninferior to the currently available 13-valent pneumococcal conjugate vaccine (PCV13). They determined that both vaccines will be recommended as a 4-dose series at 2, 4, 6, and 12 to 15 months and that the two can be used interchangeably.
The final vote gave the green light to a second MMR vaccine, Priorix (GSK), for use as an option in the U.S. in people aged 6 months or older. Previously, only Merck’s MMR vaccine was available for use until the FDA approved GSK’s shot in early June.
Priorix’s safety was evaluated in six clinical studies, during which a total of 12,151 participants received at least one dose, including 8,780 children aged 12 to 15 months, 2,917 children aged 4 to 6 years, and 454 adults and children aged 7 years or older. Overall, they found that Priorix had a similar safety profile to the other vaccine, with the most reported adverse reactions being pain, redness, swelling, loss of appetite, irritability, drowsiness and fever.
Based on these results, the committee voted 15-0 in favor of introducing this second MMR vaccine for use in the U.S.
“MMR vaccination rates in the U.S. were already low before the pandemic and are dropping still for a number of reasons, including misinformation,” said Patricia A. Stinchfield, RN, MS, CPNP, of the Children's Hospitals and Clinics of Minnesota. “The MMR additional option is so good, and we have to put them to use.”
GSK announces US FDA approval of Priorix for the prevention of measles, mumps and rubella in individuals 12 months of age and older. https://www.gsk.com/en-gb/media/press-releases/gsk-announces-us-fda-approval-of-priorix-for-the-prevention-of-measles-mumps-and-rubella-in-individuals-12-months-of-age-and-older/. Published on June 6, 2022. Accessed on June 22, 2022.
U.S. FDA Approves Merck’s VAXNEUVANCE (Pneumococcal 15-valent Conjugate Vaccine) for the Prevention of Invasive Pneumococcal Disease in Infants and Children. https://www.merck.com/news/u-s-fda-approves-mercks-vaxneuvance-pneumococcal-15-valent-conjugate-vaccine-for-the-prevention-of-invasive-pneumococcal-disease-in-infants-and-children/. Published on June 22, 2022. Accessed on June 22, 2022.