Practice Alert: 2016 Adult Immunization schedule includes new vaccines approved by CDC

The 2016 adult immunization schedule contains several changes from past years, including the addition of recently licensed meningococcal serogroup B and human papillomavirus vaccines and a revision to the recommendation for pneumococcal vaccination.

The Recommended Adult Immunization Schedule: United States, 2016, was approved by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices in October 2015 and published online February 2 in the Annals of Internal Medicine and on the Centers for Disease Control and Prevention website.

The 2016 adult immunization schedule, including separate charts for routine immunizations and for vaccines that might be indicated on the basis of medical or other indications, plus footnotes, was reviewed and approved by the American College of Physicians, American Academy of Family Physicians, American College of Obstetricians and Gynecologists, and American College of Nurse-Midwives.

New recommendations have been added for use of two recently licensed serogroup meningococcal B vaccines: Trumenba (Wyeth Pharmaceuticals), licensed in October 2014, and Bexsero (Novartis), licensed in January 2015.

A new row had been added to the chart for the “MenB” vaccine series, which should be administered to certain groups of persons aged 10 years and older who are at increased risk for serogroup B meningococcal disease. The MenB series can also be given to adolescents and young adults aged 16 through 23 years (preferred age is 16 - 18 years) to provide short-term protection against most strains of serogroup B meningococcal disease.

For human papillomavirus immunization, the new vaccine nomenclature has been changed to “9vHPV,” to denote Merck’s Gardasil 9, which was licensed in December 2014 to replace the prior 4-valent version. 9vHPV has been added to the adult schedule and can be used for routine vaccination of females and males against HPV.

For pneumococcal immunization, the interval recommendation has been changed between receipt of the 13-valent pneumococcal conjugate vaccine followed by 23-valent pneumococcal polysaccharide vaccine from “6 to 12 months” to “at least 1 year” for immunocompetent adults aged 65 years and older.

For adults aged 19 years or older who have immunocompromising conditions, anatomic or functional asplenia, cerebrospinal fluid leak, or cochlear implants, that interval is at least 8 weeks.

Other notable changes to the charts include the following:

• The row for “Meningococcal” was retitled “Meningococcal 4-valent conjugate (MenACWY) or polysaccharide (MPSV4)” to indicate that two types of serogroup A, C, W, and Y meningococcal vaccines are available for adults.
• Additional text was added in several indication bars to describe reasons for alternate dosing schedules for vaccines where such designations were appropriate. (For example, in the “Measles, mumps, and rubella” indication bar that states “1 or 2 doses,” the clause “depending on indication" was added.)
• The text in the “Hepatitis A” indication bar was revised from “2 doses” to “2 or 3 doses depending on vaccine" to account for the hepatitis A and hepatitis B combination vaccine that is administered in a three-dose series.

Source: Miriam E. Tucker, Medscape Medical News