ACIP adopts new guidance for PCV13 vaccine

Children with high-risk conditions should be given the 13-valent pneumococcal conjugate vaccine (PCV13) even if they already received the 7-valent formulation or the 23-valent pneumococcal polysaccharide vaccine.

The new, stronger recommendations from the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) were adopted at ACIP’s meeting in February.

The PCV13 vaccine protects against 13 strains of Streptococcus pneumoniae. Upgrading to a category A recommendation means that the vaccine now should be routinely used in children aged 6 through 18 years with high-risk conditions such as functional or anatomic asplenia (including sickle cell disease), cochlear implants, cerebrospinal fluid leaks, HIV infection or other immunocompromising conditions, chronic renal failure and nephrotic syndrome, and any condition that requires immunosuppressive drugs or radiation therapy.

Children with these high-risk conditions have a dramatically increased risk of invasive pneumococcal disease compared with healthy children. For example, those children with hematologic malignancies have a 1,068 times higher risk, those with HIV/AIDS have a 158 times higher risk, and children with sickle cell disease a 43.5 times higher risk.

Clinical trials showed that PCV13 is immunogenic and safe when used in these high-risk groups and that benefits for these children likely outweigh any harm associated with immunization. The stronger recommendations now align with similar recommendations for high-risk children aged 2 through 5 years and for high-risk adults aged 19 years and older.

The new guidance will be finalized after the director of the CDC accepts it and it is published later this year in the Morbidity and Mortality Weekly Report.