CDC advisory committee updates recommendations for pneumococcal, zoster vaccines
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The CDC’s Advisory Committee on Immunization Practices made new recommendations Wednesday for adult pneumococcal and herpes zoster vaccination.
The committee voted 15-0 to recommend the 20-valent pneumococcal conjugate vaccine by itself or the 15-valent vaccine followed by the 23-valent vaccine for adults aged 65 years or older who have not received a pneumococcal conjugate vaccine before — or whose vaccination status is unknown — and people aged 19 to 64 years who have an underlying medical condition or other risk factors and who also have not received a pneumococcal vaccine.
It also voted 15-0 to recommend two doses of recombinant zoster vaccine given at least 4 weeks apart for people aged 19 years or older who are or will be immunodeficient or immunosuppressed due to disease or therapy.
Patients covered by the zoster vaccine recommendation include — but are not limited to —recipients of hematopoietic stem cell or solid organ transplants, patients with hematologic or solid tumor malignancies, people with HIV, or patients with primary immunodeficiencies or autoimmune and inflammatory conditions who are on immunosuppressive medications or therapies.
Katherine A. Poehling, MD, MPH, professor of pediatrics and epidemiology and prevention at Wake Forest School of Medicine, said the pneumococcal work group — which she chairs — updated its proposed recommendation for the pneumococcal vaccine from its meeting last month because the voting questions were originally unclear due to being based on the vaccines rather than the clinical groups receiving them.
“The feedback was very clear,” Poehling said. “It was confusing to have different age-based recommendations.”
Miwako Kobayashi, MD, MPH, a CDC epidemiologist in the pneumococcal work group, said some members of the group preferred a recommendation that began at age 50 years. Members asked to amend the recommendation to reduce the age, but it was voted against 11-4.
Tara Anderson, DVM, MPH, PhD, the CDC lead on the herpes zoster work group, noted during a presentation on zoster vaccines that “the risk of zoster and its complications are generally higher in immunocompromised groups.”
According to Anderson, approximately 7 million adults have self-reported being immunosuppressed, and before a vaccine was available, approximately a million cases of herpes zoster occurred annually.
She said age-specific incidence rates among some people aged 21 to 50 years are comparable to or substantially higher than the rates in healthy adults aged older than 60 years.
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CDC. Advisory Committee on Immunization Practices (ACIP). https://www.cdc.gov/vaccines/acip/index.html. Accessed Oct. 20, 2021.
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