In This Issue
Division of Bacterial Diseases (DBD) News Bulletin
Tdap Vote: Streamlining the Adult Recommendation
In February 2012, ACIP voted to recommend that all adults aged 19 years and older, who have not yet received a dose of Tdap, should receive a single dose. Tdap can be administered regardless of interval since last tetanus or diphtheria-toxoid containing vaccine. After receipt of Tdap, persons should continue to receive Td for routine booster immunization against tetanus and diphtheria, according to previously published guidelines.
Providers should not miss an opportunity to vaccinate persons aged 65 years and older with Tdap. Therefore, providers may administer the Tdap vaccine they have available. When feasible, Boostrix (GSK) should be used for adults 65 years and older; however, either vaccine product administered to a person 65 years or older provides protection and may be considered valid.
PCV13 Licensed for Adults and Recommended for Immunocompromised Adults
FDA licensed PCV13 for adults age 50 years and older in December 2011. At its February 2012 meeting, the Advisory Committee on Immunization Practices (ACIP) reviewed the evidence for the use of PCV13 in adults but did not vote on recommendations for its use in adults. Two critical data elements are needed to fill the gaps in evidence that are required to inform an ACIP vote on routine use of PCV13 among adults: (1) results from a large clinical trial underway in the Netherlands that is studying the effectiveness of PCV13 against pneumococcal pneumonia among adults; and (2) data that will tell us if use of the vaccine in children also prevents disease among adults. An ACIP recommendation is not needed for a clinician to administer PCV13 to adults according to its FDA-approved indication. Physicians can use the vaccine for people 50 and older consistent with the labeled indication.
On June 20, 2012, ACIP voted to recommend that adults 19 years of age or older with immunocompromising conditions, functional or anatomic asplenia, CSF leaks or cochlear implants, and who have not previously received PCV13 or PPSV23 receive a single dose of PCV13 followed by a dose of PPSV23 at least 8 weeks later. They also voted to recommend that adults 19 years of age or older with immunocompromising conditions, functional or anatomic asplenia, CSF leaks or cochlear implants, and who have previously received one or more doses of PPSV23 receive a dose of PCV13 one or more years after the last PPSV23 dose was received. For those that require additional doses of PPSV23, the first such dose should be given no sooner than 8 weeks after PCV13 and at least 5 years since the most recent dose of PPSV23. Current recommendations for PPSV23 for adults 19 years of age or older with immunocompromising conditions remain unchanged.
Change in Administration for Anthrax Vaccine Absorbed
Data from CDC’s Anthrax Vaccine Research Program (AVRP) provided the evidence for FDA approval in May of changes to the label for pre-exposure use of anthrax vaccine adsorbed (AVA, BioThrax). Under the new 3-dose primary series recommendation, AVA will safeguard 66% more personnel in one-third the time with an anticipated 50% reduction in local adverse events, and will require only half the number of doses compared with the original licensed schedule. It will also provide a significant cost reduction per schedule. FDA approval of a 3-dose primary series for AVA (BioThrax) represents the successful culmination of this CDC program. DBD/MVPDB will continue to work with the AVA manufacturer to explore additional reductions in the booster schedule. The Microbial Pathogenesis and Immune Response (MPIR) Laboratory and Brian Plikaytis from the Statistics Office made significant contributions to this research.
OD New and Staff Notes (continued)...
DBD Responds to Pertussis Epidemic – Washington, 2012 - On April 3, 2012 Washington’s Secretary of Health Mary Selecky announced that pertussis had reached epidemic levels in Washington. In Washington, there have been 2,786 cases reported statewide through June 30, 2012, compared to 201 reported cases in 2011 during the same time period. DBD has been assisting in the response to this epidemic through an Epi-Aid during May with continued surveillance and epidemiological support. DBD, in collaboration with NCIRD’s Health Communication Science Office, has been providing communications and education support to Washington by creating and editing PSAs, hosting a continuing education webcast, and conducting ethnic media round tables, among other efforts. A satellite radio media tour is planned for Washington and 4 other high incidence states during the week of July 23. More information on Washington’s epidemic.
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