Members of the CDC’s Advisory Committee on Immunization Practices, or ACIP, unanimously voted to approve the 2018 adult immunization schedule, which contains “big changes” to zoster and mumps vaccinations.
The draft includes the new recommendation that herpes zoster subunit vaccine be administered over zoster vaccine live in adults aged 50 years and older even those who were previously vaccinated with zoster live vaccine.
Specifically, David K. Kim, MD, of CDC, noted that the draft of the 2018 schedule recommends that two doses of herpes zoster subunit vaccine (HZ/su) be administered 8 weeks apart to adults aged 50 years or older, even if the patient had a past episode of herpes zoster or past history of zoster vaccine live (ZVL). In addition, the draft states that two doses of HZ/su should be administered 8 weeks apart at least 8 weeks after ZVL in adults aged 50 years of older who previously received ZVL.
After discussion with the panel, ACIP established that HZ/su is not contraindicated in pregnant women or adults with immunocompromised conditions and that the vaccine should be administered with two doses. HZ/su is preferred over ZVL in healthy adults aged 50 years and older to prevent shingles and related complications, according to ACIP.
Another update to the schedule included a change to the recommendation for the measles, mumps and rubella vaccination (MMR). The new recommendation states that one additional dose of MMR should be administered to adults who previously received two doses of measles-containing vaccine who are at increased risk for mumps due an outbreak as identified by public health officials.
The 2018 adult immunization schedule will also reflect a change ACIP made last year to the recommendation for the HPV vaccination series, which advised that adults should receive two to three doses depending on age at series initiation, Kim said. The ACIP tried to harmonize the child and adult schedules when possible, he noted.
“This is important because the number of doses of HPV vaccine that an adult should get depends on the number he or she got or didn’t get as a child,” he said.
The recommendation for the traditional tetanus and diphtheria (Td) vaccine and tetanus-diphtheria-acellular pertussis (Tdap) vaccine has been updated to state that one dose Tdap should be administered to adults, then a Td booster should be given every 10 years, according to Kim.
The 2018 draft also includes additional information on vaccination for special populations, including pregnant women, adults with asplenia and adults with immunocompromising conditions, according to Kim.
There are no changes to contraindications or precautions for vaccines, Kim said.
Kim said that if approved, the schedule is projected to be published in February 2018. – by Alaina Tedesco
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