2014 updates from the cdc s advisory committee on immunization practices acip
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2014 UPDATES FROM THE CDC’S ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES (ACIP). William Schaffner, MD Professor of Preventive Medicine and Infectious Diseases Vanderbilt University School of Medicine Consultant, Communicable Disease Control Tennessee Department of Health.

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2014 updates from the cdc s advisory committee on immunization practices acip

2014 UPDATES FROM THE CDC’S ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES (ACIP)

William Schaffner, MD

Professor of Preventive Medicine and Infectious Diseases

Vanderbilt University School of Medicine

Consultant, Communicable Disease Control

Tennessee Department of Health

conflict of interest
Conflict of Interest

Merck: Member, Data Safety Monitoring Board

Pfizer: Member, Data Safety Monitoring Board

Sanofi-Pasteur: One lecture

outline
Outline

ACIP – what it is

Tdap safety in pregnancy

Influenza

Pneumococcal

HPV

advisory committee on immunization practices acip
Advisory Committee on Immunization Practices (ACIP)

15 Members: vaccinology, public health, academia

1 Lay person – represents the public

3 Meetings/yr Work Groups

Collaboration with professional societies

Publish recommendations on vaccine use

50+ years

slide6

ACIP also functions as the determining committee for Vaccines for Children program (VFC)

Has authorization and appropriation function

Guides private medical insurance coverage for children, less reliably insurance for adults

slide7

Vaccines one of the great public health success stories of the 20th century – and more is expected of them in the 21st century

Vaccines save $3-$10 for every dollar spent on them

Among Children, vaccines have essentially eliminated healthcare disparities: income, race/ethnicity, rural/urban

Disparities in vaccine-preventable diseases and vaccine use still exist among adults

safety of tdap in pregnancy
Safety of Tdap in Pregnancy

Oct, 2011: Unvaccinated pregnant women should receive a dose of Tdap

Oct, 2012: Tdap recommended during every pregnancy

Feb, 2014: Tdap during pregnancy was not associated with increased risk of birth outcomes

immunization during pregnancy
IMMUNIZATION DURING PREGNANCY
  • Tdap during every pregnancy
  • Influenza
influenza
Influenza

ACIP: Everyone ≥ 6 months of age

June, 2014: ACIP expressed a preference for live attenuated vaccine (LAIV) for children 2-8 years old when the vaccine is available

Immunization should not be delayed

pneumococcal vaccine s for adults 65 years old
PNEUMOCOCCAL VACCINE(S)FOR ADULTS ≥ 65 YEARS OLD

Pneumococcal polysaccharide vaccine (PPS 23)

All ≥ 65 years of age

Pneumococcal conjugate vaccine (PCV13)

Licensed for adults ≥ 50 late Dec, 2011

acip waiting for
ACIP WAITING FOR
  • Indirect effect of vaccinating children with PCV13
  • Results of CAPITA Trial – effect of PCV13 on community-acquired pneumonia (CAP)
results
RESULTS
  • Indirect effect substantial

Nevertheless est. 5,000 (2,500-15,000)

potentially preventable cases of CAP

  • CAPITA 75% reduction in invasive pneumococcal disease

45% reduction in CAP

august 2014 new recommendation for pneumococcal vaccination 65 years of age
AUGUST, 2014 NEW RECOMMENDATION FOR PNEUMOCOCCAL VACCINATION ≥ 65 YEARS OF AGE

No Vaccine before: PCV13 followed by PPSV23

6-12 months later

Previously vaccinated with PPSV23 – give PCV13

1 year or longer

difficulties
DIFFICULTIES
  • Educating providers
  • Medicare coverage
  • Keeping track of vaccinations
human papillomavirus vaccine hpv
HUMAN PAPILLOMAVIRUS VACCINE(HPV)

Adolescents (age 13-17 years) – 2013

USATN

Girls ≥ 1 dose 57% 49%

≥ 2 doses 48% 40%

≥ 3 doses 38% 36%

Boys ≥ 1 dose 35% 29%

≥ 2 doses 24% 18%

≥ 3 doses 14% ---

slide17

Disease is BAD 

Vaccines are GOOD 

slide18

When meditating over a disease, I never think of finding a remedy for it, but, instead, a means of preventing it.

Louis Pasteur

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