Immunization News

Table of Contents

• Most current updates (updated 7/24/2017)
• Highlighted topics
  • Advisory Committee on Immunization Practices (ACIP) recommendations
  • Food and Drug Administration (FDA) approvals
  • New York State (NYS) laws and regulations
  • Vaccine-preventable diseases and outbreaks
  • Resources and job aids
  • Vaccine shortages or delays

Most Current Updates

• Updated ACIP recommendations for use of MenB-FHbp serogroup B meningococcal vaccine: In May 2017, the ACIP published updated recommendations for use of MenB vaccines. Healthy adolescents and young adults aged 16 – 23 years may be administered either 2 doses of MenB-FHbp (Trumenba, Pfizer) or MenB-4C (Bexsero) (Category B recommendation, made for individual decision making). Persons aged 10 or more years at increased risk for serogroup B meningococcal disease should receive either 3 doses of MenB-FHbp or 2 doses of MenB-4C (Category A recommendation). The recommendations for MenB-4C have not changed.
• Updated guidance for assessment of poliovirus vaccination status and vaccination of children who have received poliovirus vaccine outside the United States (errata): The ACIP continues to recommend that all U.S. infants and children be immune to all three poliovirus types. However, in April 2016, all countries that still use oral polio vaccine (OPV) switched from trivalent to bivalent OPV. Therefore, children vaccinated with OPV on or after April 2016 are not immune to all three poliovirus types and should be revaccinated in the U.S. with trivalent IPV. In addition, serologic testing for antibodies against poliovirus type 2 are becoming increasingly unavailable in the U.S. For this reason, the CDC no longer recommend serologic testing for poliovirus immunity. Children without adequate documentation of poliovirus vaccination should complete the poliovirus vaccine series with doses of IPV.
• The Centers for Disease Control and Prevention (CDC) have released a 2017 digital supplement to the 13th Edition of “Epidemiology and Prevention of Vaccine-Preventable Diseases”, also known as the Pink Book. The supplement reflects the latest ACIP recommendations since the latest publication of the Pink Book in 2015. The supplement includes updates to Chapter 11: Human Papillomavirus, Chapter 14: Meningococcal Disease, Chapter 17: Pneumococcal Disease, selected references and minor errata. The Pink Book supplement is a resource intended for immunization providers, and includes supplementary immunization information on human papillomavirus vaccine, meningococcal vaccines, and pneumococcal vaccines.
• On October 25, 2016, the NYSDOH Bureau of Immunization and AIDS Institute issued new guidance regarding the use of meningococcal vaccine for HIV-infected individuals and those at high risk of HIV infection.
• CDC recommends only two human papillomavirus (HPV) shots for younger adolescents: On October 19, 2016, the ACIP recommended that 11 and 12 year olds receive two doses of HPV vaccine at least six months apart rather than the previously recommended three doses to protect against cancers caused by HPV infections. Adolescents ages 13-14 years who have not yet completed the HPV vaccine series may also receive HPV vaccination on the new two-dose schedule. Older teens and young adults who start the series later, at ages 15-26 years, will continue to need three doses of HPV vaccine to protect against cancer-causing HPV infection.
• Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the ACIP - United States, 2016-17 Influenza Season, August 26, 2016.
• ACIP votes down use of LAIV for the 2016-17 flu season: On June 22, 2016, the ACIP voted that live attenuated influenza vaccine (LAIV), also known as the “nasal spray” flu vaccine, should not be used during the 2016-17 flu season. The ACIP continues to recommend annual flu vaccination, with either the inactivated influenza vaccine (IIV) or recombinant influenza vaccine (RIV), for everyone 6 months and older.
• On May 23, 2016, the FDA approved an expanded age indication for Flucelvax (cell culture-based IIV) for immunization of persons 4 years of age and older against influenza virus subtypes A and B.
• On December 14, 2015, the FDA approved an expanded age indication for administration of 9-valent human papillomavirus vaccine (9vHPV; brand name Gardasil 9) to boys and men 16 through 26 years of age for the prevention of anal cancer, genital warts, and anal intraepithelial neoplasia caused by HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58. The ACIP has recommended the use of 9vHPV vaccine in males this age range since February, 2015.
• Use of Serogroup B Meningococcal Vaccines in Adolescents and Young Adults, October 23, 2015.

ACIP recommendations

• A list of all current and archived ACIP recommendations can be found online at www.cdc.gov/vaccines/hcp/acip-recs/. For your convenience, newer ACIP recommendations are listed below.
• Updated ACIP recommendations for use of MenB-FHbp serogroup B meningococcal vaccine: In May 2017, the ACIP published updated recommendations for use of MenB vaccines. Healthy adolescents and young adults aged 16 – 23 years may be administered either 2 doses of MenB-FHbp (Trumenba, Pfizer) or MenB-4C (Bexsero) (Category B recommendation, made for individual decision making). Persons aged 10 or more years at increased risk for serogroup B meningococcal disease should receive either 3 doses of MenB-FHbp or 2 doses of MenB-4C (Category A recommendation). The recommendations for MenB-4C have not changed.
• Updated guidance for assessment of poliovirus vaccination status and vaccination of children who have received poliovirus vaccine outside the United States (errata): The ACIP continues to recommend that all U.S. infants and children be immune to all three poliovirus types. However, in April 2016, all countries that still use oral polio vaccine (OPV) switched from trivalent to bivalent OPV. Therefore, children vaccinated with OPV on or after April 2016 are not immune to all three poliovirus types and should be revaccinated in the U.S. with trivalent IPV. In addition, serologic testing for antibodies against poliovirus type 2 are becoming increasingly unavailable in the U.S. For this reason, the CDC no longer recommend serologic testing for poliovirus immunity. Children without adequate documentation of poliovirus vaccination should complete the poliovirus vaccine series with doses of IPV.
• On October 25, 2016, the NYSDOH Bureau of Immunization and AIDS Institute issued new guidance regarding the use of meningococcal vaccine for HIV-infected individuals and those at high risk of HIV infection.
• CDC recommends only two human papillomavirus (HPV) shots for younger adolescents: On October 19, 2016, the ACIP recommended that 11 and 12 year olds receive two doses of HPV vaccine at least six months apart rather than the previously recommended three doses to protect against cancers caused by HPV infections. Adolescents ages 13-14 years who have not yet completed the HPV vaccine series may also receive HPV vaccination on the new two-dose schedule. Older teens and young adults who start the series later, at ages 15-26 years, will continue to need three doses of HPV vaccine to protect against cancer-causing HPV infection.
• Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the ACIP - United States, 2016-17 Influenza Season, August 26, 2016.
• ACIP votes down use of LAIV for the 2016-17 flu season: On June 22, 2016, the ACIP voted that live attenuated influenza vaccine (LAIV), also known as the “nasal spray” flu vaccine, should not be used during the 2016-17 flu season. The ACIP continues to recommend annual flu vaccination, with either the inactivated influenza vaccine (IIV) or recombinant influenza vaccine (RIV), for everyone 6 months and older.
• Use of Serogroup B Meningococcal Vaccines in Adolescents and Young Adults, October 23, 2015.
• Intervals Between PCV13 and PPSV23 Vaccines, September 4, 2015.

FDA approvals

• On November 18, 2016, the FDA approved an expanded age indication for FluLaval Quadrivalent to include children 6 to 35 months of age. FluLaval Quadrivalent will be available as either a 0.5 mL single-dose prefilled syringe or as a 5.0 mL multi-dose vial. Additional information on available influenza vaccines for the 2016-17 season is available on the CDC website.
• On May 23, 2016, the FDA approved an expanded age indication for Flucelvax (cell culture-based IIV) for immunization of persons 4 years of age and older against influenza virus subtypes A and B.
• On April 14, 2016, the FDA approved a change for Trumenba MenB vaccine to include a 2-dose schedule, separated by 6 months.
• On December 14, 2015, the FDA approved an expanded age indication for administration of 9-valent human papillomavirus vaccine (9vHPV; brand name Gardasil 9) to boys and men 16 through 26 years of age for the prevention of anal cancer, genital warts, and anal intraepithelial neoplasia caused by HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58. The ACIP has recommended the use of 9vHPV vaccine in males this age range since February, 2015.

NYS laws and regulations

• New meningococcal vaccine requirement for grades 7 and 12: Beginning September 1, 2016, children entering or attending grades 7 and 12 in NYS will be required to be vaccinated against meningococcal disease as recommended by the ACIP. Additional details on this requirement will be shared with schools, healthcare providers and parents as soon as possible.
• A summary of all NYS immunization laws and regulations is available online

Vaccine-preventable diseases and outbreaks

• Influenza Activity, Surveillance and Reports
• Measles Cases and Outbreaks (CDC)
• Pertussis (Whooping Cough) Outbreaks (CDC)
• Mumps Cases and Outbreaks (CDC)
• Chickenpox (Varicella) Outbreaks (CDC)

Resources and job aids

• Pneumococcal Vaccination Algorithm for Adults aged 65 years or Older (PDF). In 2014, the ACIP issued updated recommendations on pneumococcal vaccination of adults aged 65 years and older. The NYSDOH has developed this algorithm to assist healthcare providers and healthcare facilities to understand and implement these recommendations.
• Pneumococcal Vaccination Algorithm for Adults aged 19-64 years (PDF). In 2012, the ACIP issued updated recommendations on pneumococcal vaccination of adults with immunocompromising conditions. The NYSDOH has developed this algorithm to assist healthcare providers and healthcare facilities to understand and implement these recommendations.

Vaccine shortages or delays

• 2016-17 Influenza Vaccine Supply Determination: The Commissioner of Health has determined that it appears that there will be an adequate supply of thimerosal-free seasonal influenza vaccine for the 2016-2017 influenza season for vaccination of pregnant women and children under the age of three years. Therefore, health care providers (physicians, nurse practitioners, physician assistants, nurse midwives) providing influenza vaccinations to pregnant women and children under 3 years of age should seek out and administer thimerosal-free seasonal influenza vaccine as soon as their thimerosal-free vaccine supplies arrive to ensure compliance with PHL § 2112.