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The June ACIP meeting took place on June 26-28. For June 26-27 meeting highlights, visit the June edition of Got Your Shots? News.
Meningococcal
On Friday, June 28, the ACIP meningococcal work group presented information on its continued discussion regarding who should receive the meningococcal pentavalent (MenABCWY) vaccine and when it should be administered. Cost effectiveness will be discussed at the October ACIP meeting, and a vote is anticipated at the February 2025 ACIP meeting.
RSV in pregnant persons and infants
The Respiratory Syncytial Virus (RSV) ACIP work group presented data on the first season of RSV vaccine for pregnant persons (Abrysvo) and nirsevimab (RSV monoclonal antibody/Beyfortus) for infants. Data showed that nirsevimab was highly effective at preventing RSV hospitalization (91-98%) and medically attended RSV-associated acute respiratory infection episodes (89%) in infants.
There are no changes to the ACIP recommendations for nirsevimab or Abrysvo for the upcoming 2024-2025 RSV season. All infants are recommended to be protected by either maternal RSV vaccination or infant nirsevimab.
At this time, persons who received a maternal RSV vaccine during a previous pregnancy are not recommended to receive additional doses during future pregnancies. Infants born to people who received the RSV vaccination during a prior pregnancy should receive nirsevimab.
As of July 18, there have been 336 confirmed and probable cases of pertussis in Minnesota, which is the highest number of reported cases since 2020.
The most recent increase in cases has predominantly affected adolescents ages 11 to 18, with a significant outbreak occurring among middle and high school students. To help prevent outbreaks, the CDC recommends Tdap as a single dose for those 11-18 years old with preferred administration at 11-12 years old.
It is also important for pregnant people to protect themselves and their babies from pertussis, especially in light of the recent outbreaks. The CDC advises that all pregnant people receive the Tdap vaccine during the early part of the third trimester (between 27 and 36 weeks). This timing optimizes the transfer of maternal antibodies to the fetus, offering the newborn protection during their first few months of life when they are most vulnerable to pertussis but too young to be vaccinated themselves.
Vaccination is crucial in preventing and reducing the spread of pertussis. Vaccination also helps protect from the most severe symptoms. Because immunity to pertussis begins to wane one to two years after vaccination, clinicians should ensure the following:
- On-time vaccination of infants, children, and adolescents according to the recommended schedule.
- Recall and catch-up of incompletely vaccinated persons including teens and adults who may not have received Tdap, especially among those who care or live with infants.
- Adults should receive a Tdap booster every 10 years.
- Among those who are pregnant, Tdap vaccination is recommended during each pregnancy.
As the new school year approaches, MDH encourages health care providers to vaccinate patients who are due or overdue for routinely recommended vaccines, which include vaccines required for school. The Current Childhood and Adolescent Immunization Coverage Rates page shows that only 73.4% of 6-year-olds are up to date on routinely recommended vaccines and only 40.5% of 13-year-olds have received routinely recommended adolescent vaccines. Public health and health care professionals can prepare students for school and increase immunization rates by taking the following actions:
- Start reminder-recall activities to notify patients due or overdue for recommended immunizations. To enroll in reminder/recall activities, visit Reminder/Recall Using Text Messages (PDF) or email health.MIICTexting@state.mn.us for more information.
- Schedule patients for their well-child visits or immunization appointments.
- Assess vaccination status of every patient at each clinical visit.
- Provide strong recommendation for all routinely recommended vaccines.
- Report administered immunizations to MIIC to ensure schools can verify students’ immunization status.
MDH has programming to support the action steps listed above:
Did you know that suspected or confirmed shingles (herpes zoster) in people under 18 is reportable in Minnesota? During the case investigation process, we provide guidance to reporters and patients on preventing the spread of varicella-zoster virus (VZV) to non-immune contacts who can develop a primary varicella infection if they are directly exposed to shingles lesions. Data collected also help MDH and CDC partners understand the changing epidemiology of shingles and monitor the impacts of the varicella vaccine.
Shingles can occur in people who had varicella disease and those vaccinated for varicella. However, those vaccinated are less likely to develop shingles, unless they have other risk factors.
It is important to consider the VZV immunity status of people who may be exposed to someone with shingles to prevent the spread of VZV to non-immune contacts. Between 2014 and 2022, out of the 960 varicella cases that had a known epidemiological link to another reported case, 20% (192) contracted varicella through exposure to someone with shingles.
MDH encourages providers to send VZV specimens to our Public Health Laboratory for strain-typing by requesting free at-home testing kits for varicella or pediatric shingles through our VPD Test Kit Requests.
For additional information on shingles disease, visit Shingles (Herpes Zoster). Shingles cases of any age that experience complications other than post-herpetic neuralgia are also reportable in MN; however, for cases over 17 years of age, we only conduct chart review and do not conduct a case investigation.
To report zoster, visit Reporting Zoster (Shingles) or complete the Vaccine Preventable Disease (VPD) Reporting Form.
Contact Health.ChickenpoxInfo@state.mn.us with it questions.
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