Errata, Updates & Clarifications
Latest Entry: 7/29/2019
Updates
Page 165 (Hepatitis B Chapter)
The paragraph beginning, “Twinrix is approved for persons 18 years of age or older . . .” should be replaced with this paragraph:
“Twinrix is approved for persons 18 years of age or older, and can be administered to persons in this age group for whom both hepatitis A and hepatitis B vaccines are recommended. Because the hepatitis B component of Twinrix is equivalent to a standard adult dose of hepatitis B vaccine, Twinrix can be administered on a single-antigen hepatitis B vaccine schedule; the minimum interval recommendations will be met. However, single-antigen hepatitis B vaccine cannot be administered on a Twinrix schedule, because the minimum intervals will be violated. Single-antigen hepatitis A vaccine can be used to complete a series begun with Twinrix or vice versa. See the ‘Hepatitis A’ chapter for details.” (7/25/2019) This change has been made to both the PDF and online html versions of the Pink Book..
Updates
Page 194 (Influenza Chapter)
In the paragraph beginning, “One inactivated influenza vaccine product, FluBlok . . .” the second sentence should be changed to read, “It is trivalent, administered by intramuscular injection, and is indicated for persons aged 18 and older.” (2/13/2019) This change has been made to the online html version of the Pink Book.
Updates
Page 374 (Varicella Chapter)
The first paragraph of the section titled Varicella Zoster Immune Globulin should be replaced with “In March 2013, a VZIG product, VariZIG (Cangene Corporation, Winnipeg, Canada) was licensed by the FDA. It had previously been available as an investigational product. Currently, VariZIG is commercially available from a broad network of specialty distributors in the United States (list available at www.varizig.comexternal icon).” (1/29/2019) This change has been made to the online html version of the Pink Book.
Appendix B
- U.S. Vaccines
Appendix E
- Impact of Vaccines in the 20th and 21st Centuries
These documents have been updated with current information. (1/29/2019) These updates have been made in the online pdf version of the Pink Book.
Clarification
Page 241 (Meningococcal Chapter)
The following text should be added to the last paragraph on Page 241.
“Among the 24 reports of death, 11 (45.8%) indicated that the cause of death was meningococcal infection (nine with a serogroup included in the vaccine and two with a nonvaccine serogroup). Among the other 13 (54.2%) reports of death, which occurred from the day of vaccination to 127 days following vaccination, stated causes of death were cardiac (five), neurologic (two), infectious (two), behavioral (i.e., suicide) (two), rheumatologic (one), and unexplained (one). There was no pattern among these reports. Except for the finding of GBS, which was further evaluated and is discussed below, no signals were identified in VAERS after MenACWY-D vaccination.” (1/29/2019) This has been corrected on the online html version of the Pink Book.
Updates
Appendix A
- Recommended Immunization Schedules for Persons Aged 0 Through 18 Years
- Recommended Adult Immunization Schedule
- Recommended and Minimum Ages and Intervals Between Doses of Routinely Recommended Vaccines
- Summary of Recommendations for Child/Teen Immunization
- Summary of Recommendations for Adult Immunization
- Recommended intervals between administration of immune globulin preparations and measles-or varicella-containing vaccine
- Healthcare Personnel Vaccination Recommendations
- Vaccination of Persons with Primary and Secondary Immune Deficiencies
- Guide to Contraindications and Precautions to Commonly Used Vaccines
- Guide to Contraindications and Precautions to Commonly Used Vaccines in Adults
Appendix B
- U.S. Vaccines
- Vaccine Excipient and Media Summary, by Vaccine
- Latex in Vaccine Packaging
Appendix C
- It’s Federal Law
- Instructions for Use of VISs
- VIS Questions and Answers
- CDC’s Vaccine Information Statement Web page
Appendix E
- Reported Cases and Deaths from Vaccine Preventable Diseases, United States, 1950-2016
- Impact of Vaccines in the 20th and 21st Centuries
- Vaccine Coverage Levels, United States, 1962-2016
Appendix F
- Contact Information: Selected Vaccine Manufacturers & Distributors
- Immunization Grantees
These documents have been updated with current information. (7/1/2018) These updates have been made in the online pdf version of the Pink Book.
Updates
Pages A-13 – A-14 (Appendix A) “Recommended and Minimum Ages and Intervals Between Doses of Routinely Recommended Vaccines”
This table has been updated to make it consistent with Table 3.1 in the ACIP’s recently-published General Best Practice Guidelines for Immunization. (6/20/2017) This update has been made in the online pdf version of the Pink Book.
Updates
Pages A-13 – A-14 (Appendix A) “Recommended and Minimum Ages and Intervals Between Doses of Routinely Recommended Vaccines”
Pages B-1 – B-4 (Appendix B) “U.S. Vaccines”
Pages D-5 – D-6 (Appendix D) “National Childhood Vaccine Injury Act: Vaccine Injury Table”
These three documents have been updated with current information. (5/11/2017) These updates have been made in the online pdf version of the Pink Book.
Updates
Pages B-7 – B-10 (Appendix B) “Vaccine Excipient and Media Summary”
Page F-1 (Appendix F) “CDC Contact Information and Resources”
Pages F-4 – F-10 (Appendix F) “Immunization Grantee List”
These three documents have been updated with current information. (2/22/2017) These updates have been made in the online pdf version of the Pink Book.
Update
Page 169 (Hepatitis B Chapter)
The table “Recommended postexposure prophylaxis for percutaneous or permucosal exposure to hepatitis B virus – Advisory Committee on Immunization Practices, United States” is adapted from two sources which contain recommendations for both non-occupational and occupational exposures, respectively. However, following publication of the Pink Book 13th edition, CDC published new recommendations for occupational exposures. For postexposure prophylaxis of an occupational exposure to hepatitis B virus, see https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6210a1.htm, Table 2. The full citation is Centers for Disease Control and Prevention. CDC Guidance for Evaluating Health-Care Personnel for Hepatitis B Virus Protection and for Administering Postexposure Management. MMWR 2013;62(No. RR-10):1-22.”
Updates
Pages A-13 – A-14 (Appendix A)
The “Recommended and Minimum Ages and Intervals . . .” table has been replaced, to add a clarifying sentence to Footnote 6. (5/5/2016) This has been corrected on the online pdf version of the Pink Book.
Page B-11 – B-12 (Appendix B)
The “Latex in Vaccine Packaging” table has been replaced to make it consistent with manufacturers’ current package inserts. (5/5/2016) This has been corrected on the online pdf version of the Pink Book.
Erratum
Page 241 (Meningococcal Chapter)
On the second figure, the bullet for “Serious adverse events” is formatted incorrectly for MenACWY-CRM, making it appear to be a subset of “Syncope” rather than a separate category. (12/11/2015) This has been corrected on the online html version of the Pink Book.
Update
Page 111 (Diphtheria Chapter)
The first sentence in the Antibiotics section should be replaced with, “The antibiotics of choice are erythromycin (500 mg four times daily for 14 days) or procaine penicillin G (300,000 units every 12 hours for patients ≤10 kg and 600,000 units every 12 hours for patients >10 kg intramuscularly) until the patient can take oral medicine, followed by oral penicillin V (250 mg four times daily) for a total treatment course of 14 days.” (11/9/2015) This change has been made to the online html version of the Pink Book.
Clarification
Page 4 (Principles of Vaccination Chapter)
In the second paragraph under the section “Classification of Vaccines,” the last sentence is misleading. It should be replaced with, “However, two live attenuated bacterial vaccines are available in the United States (Ty21a and BCG). BCG is not used as a vaccine, but as a treatment for bladder cancer.” (9/8/2015) This change has been made to the online html and pdf versions of the Pink Book.
Erratum
Page 7 (Principles of Vaccination Chapter)
In the section titled Polysaccharide Vaccines, the last bullet on the figure under “Recombinant Vaccines” should be changed from, “Bacterial: Salmonella Typhi (Vi)” to “Bacterial: Salmonella Typhi (Ty21a).” (9/8/2015) This change has been made to the online html and pdf versions of the Pink Book.
Update
Page 11 (General Recommendations Chapter)
(1) In the footnote under the “General Rule” callout, “*exception: In children with functional or anatomic asplenia . . .” should be changed to “*exception: In persons with functional or anatomic asplenia . . .” (2) In the figure, the footnote beginning “*in children with functional or anatomic asplenia . . .” should be changed to “*in persons with functional or anatomic asplenia . . .” (9/29/2015) This change has been made to the online html version of the Pink Book.
Update
Page 11 (General Recommendations Chapter)
The last paragraph on this page can benefit from slightly updated recommendations and more detail regarding spacing of Menactra and PCV13. (9/29/2015) This paragraph has been replaced in the online html version of the Pink Book.
Erratum
Page 11 (General Recommendations on Immunization Chapter)
Under the heading Simultaneous and Nonsimultaneous Administration, the last bullet on the figure should be changed from, “Exception is yellow fever vaccine given less than 4 weeks after measles vaccine, mumps vaccine, rubella vaccine, or varicella vaccine” to “Exception is yellow fever vaccine given less than 30 days after single antigen measles vaccine, single antigen mumps vaccine, single antigen rubella vaccine, or varicella vaccine.” (9/8/2015) This change has been made to the online html and pdf versions of the Pink Book.
Clarification
Page 12 (General Recommendations on Immunization Chapter)
Under the heading Nonsimultaneous Administration of Different Vaccines, the last sentence of the first paragraph lacks precision. It should read, “So doses of mumps, varicella, zoster, LAIV, and rubella, when administered less than 30 days prior to yellow fever vaccine, can be counted.” (9/8/2015) This change has been made to the online html and pdf versions of the Pink Book.
Clarification
Page 27 (General Recommendations on Immunization Chapter)
In the second paragraph under the section Tuberculin Skin Test, the word “containing” should be added to the last sentence, so it will now read, “Until such information is available, it is prudent to apply rules for spacing measles vaccine and TST to varicella-containing vaccine and LAIV.” (9/8/2015) This change has been made to the online html and pdf versions of the Pink Book.
Erratum
Page 51 (Vaccine Safety Chapter)
In the paragraph headed National Childhood Vaccine Injury Act (NCVIA) of 1986, the second use of the acronym “NCVIA” was erroneously printed “NVCIA.” (9/8/2015) This change has been made to the online html and pdf versions of the Pink Book.
Erratum
Page 101 (Vaccine Administration Chapter)
Under the heading Documentation, the bulleted lists in both the text and in the figure headed “Documentation in Permanent Medical Record” erroneously contain the bullet “Expiration date.” They should be removed. (9/8/2015) These changes has been made to the online html and pdf versions of the Pink Book.
Errata
Pages 128 & 129 (Hib Chapter)
(1) The two paragraphs headed PRP-T (ActHIB) [p. 128] and PRP-OMP (PedvaxHIB) [p. 129] each contain a sentence that begins, “Unvaccinated children aged 7 through 11 months should receive two doses of vaccine 2 months apart . . . ” In each case, “2 months” should be replaced with “4 weeks.” (2) The first paragraph on p. 129 begins with, “Unvaccinated children aged 2 through 11 months . . .” This should be changed to read, “Unvaccinated children aged 2 through 6 months . . .” (9/29/2015) These changes have been made to the online html version of the Pink Book.
Erratum
Page 175 (Human Papillomavirus Chapter)
On the first figure, under the heading “Human Papillomavirus Types and Disease Association,” the text under the far-left arrow should include an additional bullet: “high-grade cervical abnormalities.” (9/8/2015) This change has been made to the online html and pdf versions of the Pink Book.
Erratum
Page 199 (Influenza Chapter)
(1) Under the heading Contraindications and Precautions to Vaccination, “Guillain-Barré” is misspelled (as “Guillian-Barré”) twice in the text and twice in the accompanying figure. (2) In the same figure, the bullets under “Live Attenuated Influenza Vaccine Contraindications and Precautions” have been updated. (9/8/2015) These changes has been made to the online html and pdf versions of the Pink Book.
Clarification
Page 269 (Pertussis Chapter)
Several changes have been made to remove the distinction between “primary” and “booster” doses of DTaP.
(1) In the first paragraph, the first sentence should be changed from, “The primary series of DTaP vaccine consists of four doses . . .” to “The series of DTaP vaccine consists of five doses . . .” (2) In the third paragraph, the first sentence should be changed from, “Children who received all four primary doses before the fourth birthday should receive a fifth (booster) dose . . .” to “Children who received four doses before the fourth birthday should receive a fifth dose . . .” (3) In the second sentence of the same paragraph, the phrase “the fourth dose in the primary series . . .” should be changed to read “the fourth dose in the series . . .” and (4) In the third sentence of the same paragraph, the phrase “The booster dose increases antibody levels . . .” should be changed to read “The fifth dose increases antibody levels . . .” (9/29/2015) These changes have been made to the online html version of the Pink Book.
Updates
Page 270 (Pertussis Chapter)
(1) In the figure Tdap Recommendations, the bullet “adults 19 through 64 years of age” should read “adults 19 and older.” (2) In the same figure, the bullet beginning “adults 65 years of age and older . . .” should be deleted. (3) In the first text paragraph under the heading Tdap, the end of the last sentence should be changed from “Adacel is approved for persons 11 through 64 years of age” to “Adacel is approved for persons 10 through 64 years of age.” (9/8/2015) These changes has been made to the online html and pdf versions of the Pink Book.
Updates
Page 289 (Pneumococcal Chapter)
Under the heading Vaccine Schedule and Use, the figure heading “Pneumococcal Conjugate Vaccine High-risk Schedule – Adults 19 through 64 years old” should be changed to “Pneumococcal Conjugate Vaccine High-risk Schedule – Adults 19 and older.” (9/8/2015) This change has been made to the online html and pdf versions of the Pink Book.
Updates
Page 290 (Pneumococcal Chapter)
(1) Under the figure heading “Pneumococcal Polysaccharide Vaccine Recommendations,” an additional bullet, “CFS leak” should be added. (2) In the second part of the same figure, heading “Pneumococcal Polysaccharide Vaccine Revaccination – High-risk Immunocompetent Persons,” the bullet beginning, “Revaccination recommended for immunocompetent persons 2 years of age . . .” should be changed: the phrase “2 years of age or older” should be changed to “2 through 64 years of age.” (9/8/2015) These changes has been made to the online html and pdf versions of the Pink Book.
Erratum
Page 304 (Poliomyelitis Chapter)
The last sentence of the last paragraph (beginning “A minimum interval of 4 weeks . . .”) should be replaced with this sentence, “The last dose should be given after the fourth birthday. A minimum interval of 4 weeks should separate all doses of the series, with the exception that if dose three and dose four are both IPV, the interval between these two doses should be six months.” (9/29/2015) This change has been made to the online html version of the Pink Book.
Clarification
Page 316 (Rotavirus Chapter)
Under the heading Vaccine Efficacy, the figure titled “Rotavirus Vaccine Efficacy” is confusing. It should read:
Rotavirus Vaccine Efficacy
- Any rotavirus gastroenteritis: 74%-87%
- Severe gastroenteritis: 85%-98%
Both vaccines significantly reduced physician visits for diarrhea, and reduced rotavirus-related hospitalization.
(9/8/2015) This change has been made to the online html and pdf versions of the Pink Book.
Clarification
Page 349 (Tetanus Chapter)
Under the heading Contraindications and Precautions to Vaccination, the following sentence should be added to the end of the first paragraph: “If moderate to severe acute illness accompanies a wound that is neither clean nor minor, the risk of withholding tetanus-toxoid vaccine outweighs the risk of administering tetanus-toxoid vaccine, so the vaccine should be given as part of wound management.” (9/8/2015) This change has been made to the online html and pdf versions of the Pink Book.
Erratum
Pages A-20 – A-23 (Appendix A)
The 5th page of the IAC document “Summary of Recommendations for Adult Immunization” was missing. (9/29/2015) The missing page has been added to the pdf version as page A-23a.