CDC immunization schedule updates

On March 16, 2022, at the 44th National Conference on Pediatric Health Care, Mary Koslap-Petraco, DNP, PPCNP-BC, CPNP, FAANP, provided an updated immunization schedule from the CDC.

Throughout the COVID-19 pandemic, there have been multiple disruptions to health care services. These include decreased administration of vaccines, leading to greater risk of vaccine-preventable diseases in children. The CDC recommends health care providers work with families to update children’s vaccines.

Children who have missed vaccines should be contacted to schedule in-person appointments, and these children could be identified using state-based immunization information systems and electronic health records. Sick child visits should also be separated from well child visits.

Methods of separating sick child visits from well child visits include scheduling them at different times of the day, reducing crowding in waiting rooms, and determining different locations for sick children and well children to visit through collaboration with health care providers.

A CDC program known as Routine Immunization Schedule for Everyone (RISE) provides strategies to ensuring vaccination. Recommendations from RISE include catching everyone up on immunizations, determining who is behind on their vaccinations, making strong vaccine recommendations, and assuring vaccines are easy to find and afford.

There were 7 vaccines added to the immunizations schedule. New COVID-19 vaccines, new abbreviations for COVID-19 vaccine products, and revised text for vaccine injury compensation were included in the updates. The pneumococcal vaccine has also been added to the catch-up schedule, with 8 weeks marking the final dose. Only children aged 12 to 59 months require a dose, regardless of risk.

Injury claims for the COVID-19 vaccines are administered through the Countermeasure Injury Compensation Program (CICP). This is because they were developed in response to a public health emergency. The national Vaccine Injury Compensation Program (VICP) resolves vaccine injury claims for most other vaccines in children and adolescents.

Another recent change was made to COVID-19 vaccine recommendations, with bivalent Pfizer-BioNTech COVID-19 vaccines recommended by the FDA in children aged 6 months to 4 years. This includes a single booster dose in these children at least 2 months after completing primary vaccination. Age-appropriate vaccine products should be administered for each dose.

A revision was made to the dengue vaccine note, clarifying the vaccine is only recommended in children afflicted with dengue previously. Children traveling to dengue-prevalent areas should not be vaccinated.

Clarification was also made for hepatitis B vaccines in children. In addition to the birth dose, infants of hepatitis B positive mothers require 3 additional vaccine doses. Certain hepatitis B vaccines were also included in the catch-up vaccination section for individuals aged 18 years. These vaccines are the Heplisav-B (DYNAVAX) and PreHevbrio(VBI Vaccines) vaccines.

The live attenuated influenza vaccine also received an update, with indications it should not be given to individuals in close contact to immunocompromised people needing a protective environment and individuals with egg allergies. Trivalent vaccines are recommended for use in the 2023 to 2024 influenza season by the World Health Organization.

In the case of a measles outbreak, information on outbreaks should be checked on the CDC’S measles outbreak website to determine what actions should be taken in individuals vaccinated against measles.

Meningitis vaccines also received an update. In children aged under 10 years needing a meningitis vaccine for travel, Menveo liquid (Groups A, C, Y, and W-135) Oligosaccharide Diptheria CRM197 Conjugate Vaccine; GSK) is not appropriate for use, according to the CDC. Brands also cannot be interchanged with meningitis B vaccines.

A special situations section was also included for the polio vaccine, detailing recommendations for adolescents aged 18 years at increased risk of polio viruses. Adolescents are at increased risk if there is no evidence of a complete vaccination series and should receive the remaining doses.

Reference

Koslap-Petraco M.2023 CDC immunization update-schedule changes national association of pediatric nurse practitioners annual conference Orlando, FL March 16, 2023. Presented at: 44th National Conference on Pediatric Health Care. March 15-19, Orlando, Florida.