June ACIP Meeting Highlights

The Advisory Committee on Immunization Practices (ACIP) met on June 21–23 to discuss RSV, polio, influenza, pneumococcal, dengue, chikungunya, mpox, meningococcal, and COVID-19 vaccines.

On the first day, ACIP voted in favor of recommending RSV vaccine for adults. Adults 60 years of age and older may receive a single dose of RSV vaccine, using shared clinical decision-making.

Over the course of the three-day meeting, the committee voted to approve the following:

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Adult polio vaccination

• Adults who are known or suspected to be unvaccinated or incompletely vaccinated against polio should complete a primary vaccination series with inactivated poliovirus vaccine (IPV).
• Booster: Adults who have received a primary series of trivalent oral polio vaccine (tOPV) or IPV in any combination and who are at increased risk of poliovirus exposure may receive another dose of IPV.

Influenza vaccination

• The U.S. influenza vaccine composition for the 2023–2024 influenza season was approved.
• All persons aged 6 months and older with egg allergy should receive influenza vaccine unless a contraindication exists. Any influenza vaccine that is otherwise appropriate for the recipient’s age and health status can be used (egg based or non-egg based).

Child pneumococcal vaccination

• Routine: Use of either pneumococcal 15-valent conjugate vaccine (PCV15) or pneumococcal 20-valent conjugate vaccine (PCV20) is recommended for all children aged 2–23 months according to currently recommended PCV dosing and schedules.
• Catch-up: For healthy children aged 24–59 months or through age 71 months for children with any underlying condition that increases the risk of pneumococcal disease with an incomplete PCV vaccination status, use of either PCV15 or PCV20 according to currently recommended PCV dosing and schedules is recommended.
• Risk conditions: Recommendations were made for children 2–18 years with any risk condition who have completed their recommended PCV doses before age 6 years and for children 6–18 years with any risk condition who have not received any dose of PCV.

Vaccines for Children (VFC) program

• VFC resolutions which reflect the updated influenza and pneumococcal vaccination recommendations for children were approved.

Many other topics were discussed, including:

• Dengue vaccine: A vote is anticipated during the October ACIP meeting.
• Chikungunya vaccine: Licensure is anticipated in August, and a vote is anticipated in February 2024.
• Maternal/pediatric RSV: Economic analyses, evidence to recommendations (EtR) framework, and clinical considerations for RSV maternal vaccine and nirsevimab were discussed.
• Mpox vaccine: Clinical guidance for use of mpox vaccines during an outbreak was discussed for children, adolescents, pregnant and breastfeeding persons, and individuals at occupational risk.
• Meningococcal vaccines: Cost effectiveness of a potential pentavalent meningococcal conjugate vaccine (Men ABCWY) was discussed, including EtR framework and draft recommendations.
• Vaccine safety: Recent vaccine safety studies were discussed, including a preliminary evaluation which found no support for an association between aluminum in vaccines and asthma by 5 years of age in Denmark.
• COVID-19 vaccines: FDA advised vaccine manufacturers to make single-strain COVID-19 booster vaccines available this fall that would target the currently circulating Omicron subvariant XBB.1.5.

Impact on IIS

• Clinical Decision Support for immunization (CDSi) rules are regularly developed and reviewed. Updates are typically available shortly after publication of ACIP recommendations in the “Morbidity and Mortality Weekly Report.”
• Updated monovalent COVID-19 vaccine boosters will likely have new CVX codes. Monitoring data quality of existing (expiring) CVX codes and new codes will be critical.

The next scheduled ACIP meeting will be October 25–27.

For a more detailed summary, view the June 28 issue of “IZ Express.”