CDC issues new vaccine recommendations

The Centers for Disease Control and Prevention has recently revised several vaccine recommendations:

Quadravalent meningococcal conjugate vaccine. The Advisory Committee on Immunization Practices (ACIP) is recommending revaccination of persons at prolonged increased risk for meningococcal disease. In a statement in the September 25th Morbidity and Mortality Weekly Report, ACIP is recommending that persons with increased susceptibility to meningococcal disease, such as those with persistent complement component deficiencies, functional asplenia, prolonged exposure such as those traveling to or living in nations where the disease is epidemic or hyperendemic, should receive a booster with the quadravalent meningococcal conjugate vaccine 5 years after their previous vaccination if they received it at age 7 or older. Children who received the first vaccine between ages 2 and 6 should be revaccinated after 3 years. Those who remain at high risk should continue to be revaccinated every 5 years. The recommended booster vaccine is the MCV4 vaccine (Menactra®).

Haemophilus influenzae type b vaccine. The FDA recently approved Hiberix® for Haemophilus influenzae type b (Hib) ending a prolonged shortage of the Hib vaccine. Hiberix is approved as a booster for children ages 15 months to 4 years who have received a primary series of shots. The Centers for Disease Control and Prevention has now issued recommendations that the vaccine can be given as early as age 12 months to facilitate timely booster vaccination. Children who missed a booster because of the recent shortage should receive a booster with any of the Hib vaccines, including Hiberix, at the earliest opportunity.

Hepatitis A vaccine. Hepatitis A vaccine is now recommended for all close household contacts and international adoptees when the children are from intermediate-risk or high-risk areas, with an initial dose being given at least 2 weeks before the child's arrival.

Quadravalent human papilloma virus vaccine. In related news, an FDA advisory panel is recommending that the quadravalent human papilloma virus vaccine (Gardasil®) be approved for males ages 9-26 to prevent genital warts. The vaccine is currently approved only for females in that age group. Meanwhile, the same FDA advisory panel has endorsed the approval of GlaxoSmithKline's Cervarix®, a bivalent HPV vaccine which targets HPV 16 and HPV 18, leading causes of cervical cancer. If approved it would also be recommended in women ages 10-25. The new vaccine protects against 2 of the HPV strains covered by Gardasil, but also contains an adjuvant, which is designed to enhance the immune system's response to these HPV strains. Whether this imparts clinical difference is yet to be seen. The FDA is yet to act on the advisory committee's recommendations.