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ACIP voted to align the Bexsero (MenB-4C, GSK) vaccine dosing regimen with the existing Trumenba (MenB-FHbp, Pfizer) recommendation. Rationale for this recommendation was based on studies showed that a slightly better immune response with a routine dosing interval of six months instead of one month. The schedule for both MenB (meningococcal B) products is now:
- Two doses for healthy adolescents (0 and 6 months) based on shared clinical decision-making.
- Three doses (0, 1-2, and 6 months) for persons aged ≥10 years old at increased risk for serogroup B meningococcal disease.
- Vaccination providers may use the three-dose schedule in situations when accelerated protection is desired, for example, if a healthy teen initiates the MenB series less than 6 months before leaving for college and there is a desire to maximize protection before college begins.
MenB vaccine products are not interchangeable. This includes the MenB portion of the MenABCWY product. For example, if Penbraya (Pfizer’s MenABCWY pentavalent vaccine) is used for the first MenB dose, the MenB series must be completed with either a dose of Trumenba (Pfizer’s MenB) vaccine or Penbraya (Pfizer’s MenABCWY vaccine).
A vote on GSK’s new MenABCWY vaccine is anticipated for Feb. 2025. ACIP will consider other adjustments to the overall adolescent meningococcal vaccination schedule/adolescent vaccination platform in 2025: CDC: Meningococcal Vaccine Recommendations.
In June, ACIP recommended high-dose (HD-IIV3) and adjuvanted inactivated influenza (aIIV3) vaccines as options without preference for use in solid organ transplant patients 18-64 years old receiving immunosuppressive medications. Because the Vaccines for Children (VFC) program includes 18-year-olds, the VFC resolution was formally modified at the October ACIP meeting to add these products as options for vaccination of solid organ transplant recipients age 18 years. More information about the availability of these vaccines for MnVFC participants will be communicated with providers when available.
Maternal RSV Vaccine is not associated with increased risk for preterm birth: A Vaccine Safety Data study of over 14,000 pregnant person who received RSVpreF vaccine (Abrsyvo) showed no association with increased risk of preterm birth (<37 weeks) or increased risk for small for gestational age (SGA) at birth. Ongoing safety data on stillbirth, acute outcomes and pre-eclampsia is being analyzed.
New RSV immunization for infants in development: Clinical trial data was presented for Merck’s RSV monoclonal antibody product, Clesrovimab. A single dose injection, given at standard dosage regardless of infant’s weight, is in phase 2b/3 clinical trials and has demonstrated 91% efficacy in preventing RSV-associated hospitalization and protection through 6 months. The FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) will review Clesrovimab for potential licensure on Dec.12, with policy considerations expected to be presented to the ACIP in Feb. 2025.
Adult RSV vaccination:
- Two studies have shown that co-administration of RSV vaccine with other respiratory vaccines (COVID-19 and influenza) is safe.
- Data showed that one dose of RSV vaccine provided cumulative protection across three RSV seasons.
- An elevated incidence of Guillain-Barre Syndrome (GBS) following RSV vaccination has been reported and is being monitored closely. While uncertainty remains regarding the magnitude of GBS risk associated with protein subunit RSV vaccines (Arexvy and Abrysvo), the benefits of RSV vaccination are still considered to outweigh the risks. There have been no reports of GBS following mRESVIA (Moderna mRNA RSV vaccine for adults).
The HPV workgroup is considering a change to the wording of its routine immunization recommendation. The current recommendation states that HPV can be given at 9 years old but is routinely given at 11 to 12 years old. Changing the wording to a routine recommendation at age 9 to 12 years would allow more flexibility for vaccine administrators.
The HPV workgroup also presented information on the duration of protection of HPV vaccine (>10 years with a single dose) and the potential for reducing the routine recommendation from 2 or 3 doses down to a single dose.
The first ACIP workgroup for cytomegalovirus (CMV) has been created and will begin its work in Nov. CMV can be passed by a pregnant person to the developing fetus and is the most common infectious cause of birth defects in the United States. Licensure of a CMV vaccine is anticipated in 2025.
The new 2025 schedules for children and adults are expected to be published online in Nov. and to be officially published in MMWR in Jan. 2025.
The next scheduled ACIP meeting will be held Feb. 26-27, 2025.
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