ACIP

November 2021

ACIP approved the following recommendations by majority vote at its November 3, 2021 meeting:

• The ACIP recommends the following groups should receive hepatitis B vaccines:
  • Adults 19 through 59 years of age
  • Adults 60 years of age and older with risk factors for hepatitis B infection
• The ACIP recommends the following groups may receive hepatitis B vaccines:
  • Adults 60 years of age and older without known risk factors for hepatitis B infection

• The ACIP approved the Recommended Child and Adolescent Immunization Schedule, United States, 2022 and the Recommended Adult immunization Schedule, United States, 2022

• The ACIP recommends pre-exposure vaccination with rVSVΔG-ZEBOV-GP vaccine for healthcare personnel¹ involved in the care and transport of suspect or confirmed Ebola virus disease patients at Special Pathogens Treatment Centers.
• The ACIP recommends pre-exposure vaccination with rVSVΔG-ZEBOV-GP vaccine for laboratorians and support staff at Laboratory Response Network (LRN) facilities that handle specimens that may contain replication-competent Ebola virus (species Zaire ebolavirus) in the United States.

• The ACIP recommends:
  • Use of JYNNEOS as an alternative to ACAM2000 for research laboratory personnel,² clinical laboratory personnel performing diagnostic testing for orthopoxviruses,³ and for designated response team members at risk for occupational exposure to orthopoxviruses.⁴
  • Use of JYNNEOS, based on shared clinical decision-making, as an alternative to ACAM2000 for healthcare personnel who administer ACAM2000 or care for patients infected with replication competent orthopoxviruses.⁵
  • Persons who are at continued risk⁶ for occupational exposure to more virulent orthopoxviruses like variola virus or monkeypox virus should receive booster doses of JYNNEOS every 2 years after the primary JYNNEOS series.
  • Persons who are at continued risk⁶ for occupational exposure to replication competent orthopoxviruses like vaccinia virus or cowpox virus should receive booster doses of JYNNEOS at least every 10 years after the primary JYNNEOS series.
  • Persons who are at continued risk⁶ for occupational exposure to orthopoxviruses, and who received an ACAM2000 primary vaccination, should receive a booster dose of JYNNEOS as an alternative to a booster dose of ACAM2000.

¹ Healthcare personnel (HCP) refers to all paid and unpaid persons serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials, including body substances (e.g., blood, tissue, and specific body fluids); contaminated medical supplies, devices, and equipment; contaminated environmental surfaces; or contaminated air. These HCP include, but are not limited to, emergency medical service personnel, nurses, nursing assistants, physicians, technicians, clinical laboratory personnel, autopsy personnel, therapists, phlebotomists, pharmacists, students and trainees, contractual staff not employed by the healthcare facility, and persons not directly involved in patient care, but who could be exposed to infectious agents that can be transmitted in the healthcare setting (e.g., clerical, dietary, environmental services, laundry, security, engineering and facilities management, administrative, billing, and volunteer personnel). Adapted from https://www.cdc.gov/infectioncontrol/guidelines/healthcare-personnel/index.html

² Research laboratory personnel are those who directly handle 1) cultures or 2) animals contaminated or infected with replication-competent vaccinia virus, recombinant vaccinia viruses derived from replication-competent vaccinia strains (i.e., those that are capable of causing clinical infection and producing infectious virus in humans), or other orthopoxviruses that infect humans (e.g., monkeypox, cowpox, and variola).

³ Clinical laboratory personnel who perform routine chemistry, hematology, and urinalysis testing, including for suspected or confirmed patients with orthopoxvirus infections, are not included in this recommendation as their risk for exposure is very low.

⁴ Public health authorities, at their own discretion, may approve a cohort of healthcare and/or public health personnel to receive primary vaccination against orthopoxviruses for preparedness purposes (e.g., first responders who might participate in a smallpox or monkeypox outbreak).

⁵ For example, those caring for patients enrolled in clinical trials for replication-competent orthopoxvirus vaccines and those caring for persons with suspected or confirmed orthopoxvirus infections (e.g., clinicians and environmental services personnel).

⁶ Continued risk refers to persistent risk due to occupational work performed. Designated public health and healthcare worker response teams approved by public health authorities are not at “continued risk” because they are vaccinated for the purposes of preparedness.

These recommendations have been adopted by the CDC Director and will become official once published in MMWR.

October 2021

ACIP approved the following recommendations by majority vote at its October 20, 2021 meeting:

• Two doses of recombinant zoster vaccine are recommended for the prevention of herpes zoster and its complications in adults aged ≥19 years who are or will be immunodeficient or immunosuppressed due to disease or therapy.
• Adults 65 years of age or older who have not previously received a pneumococcal conjugate vaccine or whose previous vaccination history is unknown should receive a pneumococcal conjugate vaccine (either PCV20 or PCV15). If PCV15 is used, this should be followed by a dose of PPSV23.
• Adults ages 19 to 64 years with certain underlying medical conditions or other risk factors* who have not previously received a pneumococcal conjugate vaccine or whose previous vaccination history is unknown should receive a pneumococcal conjugate vaccine (either PCV20 or PCV15). If PCV15 is used, this should be followed by a dose of PPSV23.

*alcoholism, chronic heart/liver/lung disease, cigarette smoking, diabetes mellitus, chronic renal failure, nephrotic syndrome, immunodeficiency, iatrogenic immunosuppression, generalized malignancy, human immunodeficiency virus, Hodgkin disease, leukemia, lymphoma, multiple myeloma, solid organ transplants, congenital or acquired asplenia, sickle cell disease or other hemoglobinopathies, CSF leak, or cochlear implant.

These recommendations have been adopted by the CDC Director and will become official once published in MMWR.

June 2021

ACIP approved the following recommendations by majority vote at its June 24-25, 2021 meeting.

• ACIP recommends 3-doses of Dengvaxia administered 6 months apart at month 0, 6, and 12, in persons 9-16 years of age with a laboratory confirmation of previous dengue infection and living in endemic areas.
• ACIP affirms the updated MMWR Recommendations and Reports, “Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2021-22 Influenza Season.”
• ACIP recommends a 2-dose [0, 7 days] intramuscular rabies vaccine series in immunocompetent persons <18 years of age for whom rabies vaccine pre-exposure prophylaxis (PrEP) is indicated.
• ACIP recommends an intramuscular booster dose of rabies vaccine, as an alternative to a titer check, for immunocompetent persons <18 years of age who have sustained and elevated risk for only recognized rabies exposures (i.e., those in risk category #3 of rabies PrEP recommendations table).  The booster dose should be administered no sooner than day 21 but no later than 3 years after the 2-dose PrEP series.

These recommendations have been adopted by the CDC Director and will become official once published in MMWR.

February 2021

ACIP approved the following recommendations by majority vote at its February 24-25, 2021 meeting.

• ACIP recommends a 2-dose [0, 7 days] intramuscular rabies vaccine series in immunocompetent persons ≥18 years of age for whom rabies vaccine pre-exposure prophylaxis (PrEP) is indicated.
• ACIP recommends an intramuscular booster dose of rabies vaccine, as an alternative to a titer check, for immunocompetent persons ≥18 years of age who have sustained and elevated risk for only recognized rabies exposures (i.e., those in risk category #3 of rabies PrEP recommendations table).  The booster dose should be administered no sooner than day 21 but no later than 3 years after the 2-dose PrEP series.

These recommendations have been adopted by the CDC Director and will become official once published in MMWR.