Review of New and Current ACIP Recommendations

by David J. Weber, MD, MPH

The Centers for Disease Control and Prevention (CDC) has just released the 2014 vaccine schedules from the Advisory Committee on Immunization Practices (ACIP).  Changes in vaccine adult schedule (19 years or older) can be found in the MMWR 2014;63:1-2 { http://www.cdc.gov/mmwr/preview/mmwrhtml/mm63e0203a2.htm?s_cid=mm63e0203a2_w} .  The schedule itself can be found at http://www.cdc.gov/vaccines/schedules/hcp/adult.html). 

Vaccines recommended for susceptible HCP include the following:

·         Mumps (2 doses):  MMR preferred (assume immune if born before 1957 except during an outbreak)

·         Measles (2 doses):  MMR preferred (assume immune if born before 1957 except during an outbreak)

·         Rubella (1 dose):  MMR preferred (indicated for all female HCP of childbearing potential)

·         Influenza (1 dose yearly)

·         Varicella (2 doses)

·         Tetanus toxoid, diphtheria toxoid, pertussis (1 dose of Tdap)

·         Hepatitis B (3 doses with quantitative anti-HBsAg titer 1-2 months after 3^rd dose):  Indicated for HCP who have potential exposure to blood or contaminated body fluids.

·         Meningococcal vaccine (1 dose; booster every 5 years if risk continues):  Indicated for lab personnel who spin cerebrospinal fluid.

New changes in the vaccine schedule relevant to HCP include:

·         Recombinant influenza vaccine (RIV) or inactivated influenza vaccine (IIV) can used among HCP with hives-only allergy to eggs.  RIV contains no egg protein and can be used among persons aged 18 to 49 years who have egg allergy of any severity.

·         A single dose of Tdap vaccine is recommended for HCP; a Td booster should be administered every 10 years thereafter.