ACIP recommends tick-borne encephalitis vaccine for lab workers, travelers
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The CDC’s Advisory Committee on Immunization Practices voted unanimously on Wednesday to recommend a vaccine for tick-borne encephalitis for laboratory workers and people traveling abroad to endemic areas.
Two recommendations covered lab workers with a potential exposure to the virus that causes tick-borne encephalitis (TB) and people moving or traveling to an endemic area who will have extensive exposure to ticks based on their planned outdoor activities and itinerary.
A third recommendation with a shared decision-making component said the vaccine, TicoVac (Pfizer), may be considered for people travelling to an endemic area who may engage in outdoor activities where ticks may be prevalent.
The vaccine was approved by the FDA in August — the first vaccine of its kind to receive approval in the U.S. It is currently marketed in about 30 countries, primarily in Europe.
Additionally on Wednesday, the ACIP voted unanimously with one abstention to recommend a cholera vaccine for children and adolescents aged 2 to 17 years who are traveling from the U.S to an area with active cholera transmission. The vaccine was already recommended for adults aged 18 to 64 years.
Susan Hills, MBBS, MTH, a medical epidemiologist in the CDC’s Arboviral Diseases Branch, presented data to the ACIP on TBE and information about the vaccine.
TBE is transmitted by the Ixodidae family of tick and is usually acquired in wooded areas during recreational activities. It is currently endemic in more than 35 countries in Asia and Europe, and there are roughly 5,000 to 10,000 cases reported annually.
There were only 11 cases among civilian U.S. travelers from 2001 to 2020, and nine cases among military personnel from 2006 to 2020.
TBE transmission can occur through aerosols. There have been more than 46 laboratory-acquired cases globally, but less than 10 cases were in U.S. labs. Vaccination can reduce risk for severe disease.
Risk for TBE occurring in U.S. travelers in endemic countries is low, Hills said. There is a risk of roughly one case per 2 million trips to an endemic-specific area during transmission season while undertaking outdoor activities in areas of tick exposure.
Jennifer P. Collins, MD, MSc, CDC lead for the cholera vaccine work group, spoke on considerations for the prevention of cholera and the use of the vaccine Vaxchora (Emergent), which was approved by the FDA in 2016 for travelers to cholera-affected regions.
According to the CDC’s Travelers Health Branch, there are currently 15 countries with active cholera transmission in Africa and Asia.
Currently, the vaccine is the only cholera vaccine authorized for use in the U.S. However, due to the COVID-19 pandemic, production of the vaccine is currently halted. Doses will begin to be available again beginning May 1.
The vaccine is a single-dose, live attenuated oral vaccine, and requires refrigeration between 36°F and 42°F.
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CDC. Advisory Committee on Immunization Practices (ACIP). https://www.cdc.gov/vaccines/acip/index.html. Accessed Feb. 23, 2022.
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