List of Errata/Updates

General Best Practice Guidelines for Immunization: Best Practices Guidance of the Advisory Committee on Immunization Practices (ACIP)

Updated August 10, 2021

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August 10, 2021

  • PAGE 33 pdf icon[38 pages]
    Timing and Spacing of Immunobiologics
    Table 3-2
    Combination vaccine Vaxelis (DTaP-IPV-Hib-HepB) has been added to “Table 3-2: FDA-licensed combination vaccines”.
  • PAGE 37 pdf icon[38 pages]
    Timing and Spacing of Immunobiologics
    Table 3-5
    The word “live” has been added to the column header of the interval column, in “Table 3-5: Recommended intervals between administration of antibody-containing products and measles- or varicella-containing vaccine, by product and indication for vaccination” to indicate that intervals following passive immunobiologics is NOT applicable to Shingrix, because this is the only licensed and U.S. available varicella-containing vaccine that is not live.
  • PAGE 59 pdf icon[21 pages]
    Contraindications and Precautions
    Table 4-1, Footnote (e)
    Footnote “e” for “Table 4-1: Contraindications and Precautions” has been revised to clarify the reason use of influenza antivirals are contraindications to LAIV. Unlike most contraindications, this designation is not because of an increased concern of adverse reactions, but because of a concern about the effectiveness of the vaccine.
  • PAGE 127 pdf icon[25 pages]
    Altered Immunocompetence
    The sentence “Doses separated by less than three months are invalid for persons with HIV infection” has been deleted from the paragraph “Children with HIV infection are at increased…….” While the minimum interval prospectively for two doses of varicella vaccine in HIV infected children is three months, the minimum interval retrospectively for two doses of varicella vaccine in HIV infected children is four weeks. That is to say, when catching up on lapsed doses prospective, forecast/schedule a three-month interval, but when retrospectively reviewing records to determine whether a dose counts and does not need to be repeated, use four weeks.
  • PAGE 136 pdf icon[25 pages]
    Altered Immunocompetence
    Table 8-1
    In “Table 8-1: Vaccination of persons with primary and secondary immunodeficiency”, in the row on complement inhibition, the drug ravulizumab (Ultomiris) was added as an agent that mimics complement deficiency.
  • PAGE 137 pdf icon[25 pages]
    Altered Immunocompetence
    Table 8-1
    In Table 8-1, in the row on HIV infection, the column on contraindicated vaccines, zoster was removed, since moderate or severe immunodeficiency from HIV is not a contraindication to Shingrix.

June 1, 2021

  • PAGE 129 pdf icon[25 pages]
    Altered Immunocompetence
    Page 129, with endnote on page 134
    Added: language allowing vaccination with HPV vaccine to persons 27 through 45 years old based on shared clinical decision-making (SCDM), regardless of previous vaccination with HPV vaccine prior to a hematopoietic cell transplant (HCT).

May 4, 2021

 

February 8, 2021

November 24, 2020

September 30, 2020

July 27, 2020

  • PAGE 54 pdf icon[19 pages]
    Contraindications and Precautions
    Table 4-1
    Five new contraindications have been added for LAIV. They are:
    1. Children aged 2 through 4 years who have received a diagnosis of asthma or whose parents or caregivers report that a health care provider has told them during the preceding 12 months that their child had wheezing or asthma or whose medical record indicates a wheezing episode has occurred during the preceding 12 months.
    2. Persons with active cerebrospinal fluid/oropharyngeal communications/leaks.
    3. Persons with cochlear implants (due to the potential for CSF leak, which might exist for some period of time after implantation. Providers might consider consultation with a specialist concerning risk of persistent CSF leak if an age-appropriate inactivated or recombinant vaccine cannot be used).
    4. Altered Immunocompetence
    5. Anatomic or functional asplenia (e.g. sickle cell disease).
  • PAGE 54 pdf icon[19 pages]
    Contraindications and Precautions
    Table 4-1
    An LAIV contraindication has been revised to reflect various clearance times for antivirals. The contraindication now reads:
    LAIV4 should not be administered to persons who have taken oseltamivir or zanamivir within the previous 48 hours, peramivir within the previous 5 days, or baloxavir within the previous 17 days.

April 23, 2020

  • PAGE 13 pdf icon[38 pages]
    Timing and Spacing of Immunobiologics
    When three doses of Hepatitis B vaccine have been administered, if the second dose was administered at least four weeks after the first dose, and the third dose (invalid) was administered less than 8 weeks after the second dose, the repeat third dose (let’s call it a fourth dose) can be administered 8 weeks after the second dose, and this fourth dose will be considered valid (as long as it is administered after 24 weeks of age) even if the fourth dose was not administered a full 8 weeks after the third dose.  In other words, we prospectively allow the minimum interval forecast rule to be violated in this circumstance.

February 21, 2020

  • PAGE 23 pdf icon[38 pages]
    Timing and Spacing of Immunobiologics
    The recommendation was changed to allow providers to administer a dose of live, injectable vaccine even if the interval after an antibody-containing blood product is not complete. The dose should be invalidated and repeated. Serology is no longer recommended to ascertain whether the dose provided protection.
  • PAGE 39 pdf icon[38 pages]
    Timing and Spacing of Immunobiologics
    Table 3-5 Footnotes
    The specific source material for understanding antibody quantities in antibody products is now listed. Also listed is the process for determining how to calculate the interval between antibody product and live, injectable vaccine, based on the quantity of antibody in the product.
  • PAGE 55 pdf icon[19 pages]
    Contraindications and Precautions
    Table 4-1
    A footnote is placed after HPV vaccine to clarify that HPV vaccine is not recommended during pregnancy.
  • PAGE 115 pdf icon[6 pages]
    Storage and Handling of Immunobiologics
    For response to out-of-range temperature readings, if a non-live vaccine is administered and then found out to have been stored at a deviated temperature, the dose should be repeated and does not need to wait an interval from the invalid dose. Shingrix is a non-live vaccine, this dose needs to be repeated and does need to wait 4 weeks after the invalid dose.

December 26, 2019

August 29, 2019

July 8, 2019

May 14, 2019

January 16, 2019

 

September 20, 2018

 

July 18, 2018

 

May 14, 2018

 

October 23, 2017

  • PAGE 30 pdf icon[38 pages]
    Timing and Spacing of Immunobiologics
    Table 3-1, Footnote (f)
    “The minimum recommended interval between DTaP-3 and DTaP-4 is 6 months. However, DTaP-4 need not be repeated if administered at least 4 months after DTaP-3. This is a special grace period of 2 months which can be used if evaluating records retrospectively. An additional 4 days cannot be added to this grace period prospectively, but can be added retrospectively.” This is to accommodate recent SME email that allows double dipping of the grace period (adding 4 days to the 2 months) for retrospective validation of series WHOSE 4th DOSE WAS ADMINISTERED AT 12 months of age. But this double dipping cannot be applied prospectively, meaning we will only allow a 4 day grace period added to a prospective 6 month interval, and we will only allow a four month interval prospectively (not four months plus four days) if the fourth dose would be  administered after 12 months of age.  CDSi has been updated to accommodate this.
  • PAGE 54 pdf icon[18 pages]
    Contraindications and Precautions
    Table 4-1
    LAIV ROW / CONTRAINDICATIONS COLUMN
    “LAIV4 should not be administered to persons who have taken influenza antivirals medications within the previous 48 hours.” To harmonize with the adult schedule.
  • PAGE 54 pdf icon[18 pages]
    Contraindications and Precautions
    Table 4-1
    Serogroup B meningococcal vaccine has been added to the Contraindications and Precautions table.
  • PAGE 54 pdf icon[18 pages]
    Contraindications and Precautions
    Table 4-1
    MMR ROW / CONTRAINDICATIONS COLUMN
    “Family history of altered immunocompetence”. To harmonize AND REFERENCED with the vaccine-specific statements to accommodate infants and toddlers with occult heritable congenital immunodeficiencies.
  • PAGE 56 pdf icon[18 pages]
    Contraindications and Precautions
    TABLE 4-1
    VARICELLA ROW / CONTRAINDICATIONS COLUMN
    “Family history of altered immunocompetence”. To harmonize AND REFERENCED with the vaccine-specific statements to accommodate infants and toddlers with occult heritable congenital immunodeficiencies.
  • PAGE 56 pdf icon[18 pages]
    Contraindications and Precautions
    Table 4-1
    VARICELLA ROW / PRECAUTIONS COLUMN
    “Receipt of specific antiviral drugs (acyclovir, famiciclovir, or valacyclovir) 24 hours before vaccination (avoid use of these antiviral drugs for 14 days after vaccination).”
  • PAGE 57 pdf icon[18 pages]
    Contraindications and Precautions
    Table 4-1
    ZOSTER ROW / PRECAUTIONS COLUMN
    “Receipt of specific antiviral drugs (acyclovir, famiciclovir, or valacyclovir) 24 hours before vaccination (avoid use of these antiviral drugs for 14 days after vaccination).”
  • PAGE 81 pdf icon[18 pages]
    Preventing and Managing Adverse Reactions
    Table 5-2
    “TREATMENT OF REFRACTORY SYMPTOMS” ROW
    Up to Date Table was incorrectly formatted so that two footnotes re: rate of epinephrine infusion were misplaced. This has been corrected.

 

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Page last reviewed: August 10, 2021
Content source: National Center for Immunization and Respiratory Diseases