• ACIP Recommends Adding COVID-19 Vaccination to All Schedules

    Vote Comes as End of Emergency Use Authorization Inches Closer

    October 27, 2022, 4:30 p.m. Scott Wilson — The CDC’s Advisory Committee on Immunization Practices voted unanimously during its Oct. 19-20 meeting to add COVID-19 vaccination to next year’s child, adolescent and adult immunization schedules. The ACIP also said COVID-19 shots should be included in the CDC's Vaccines for Children program, which each year provides millions of kids with free inoculations against a number of infectious diseases.

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    “The addition of the COVID-19 vaccines to the child/adolescent and adult immunization schedules is welcome,” Pamela Rockwell, D.O., of Ann Arbor, Mich., the AAFP's liaison to the ACIP, said in an email to AAFP News. “COVID-19 continues to threaten public health in the U.S. and globally. For the second year in a row, COVID-19 was the third-leading cause of death in the U.S., after heart disease and cancer.”

    If approved by the CDC director, the ACIP’s recommendation means physicians will be able to “quickly ascertain CDC recommendations for vaccination for the prevention of COVID-19 disease based on age and medical conditions,” she added. “Hyperlinks added to the schedule around COVID-19 vaccines are also a helpful to accurately determine when booster shots are recommended and for whom.”

    The move presages the expected winding down next year of the COVID-19 public health emergency and the emergency use authorization of the related vaccines. At least one COVID-19 vaccine manufacturer has announced a price increase that would take effect after the federal government stops purchasing doses.

    Contrary to misinformation spreading on social media, the recommendation does not constitute a vaccine mandate, although the agency’s immunization schedules are touchstones for state and local officials determining public health policy. Twenty-one states have passed laws prohibiting school districts from requiring COVID-19 vaccinations for students.

    The group also voted to recommend an updated pneumococcal conjugate vaccine, PCV20, for a larger patient population, including for older patients who have received other pneumococcal vaccines. Because PCV20 is designed to prevent some pneumococcus serotypes not covered by older formulations PCV13 and pneumococcal polysaccharide vaccine, the ACIP recommended that adults who had received one PCV13 dose complete the vaccination series with PCV20 or PPSV23.

    Following news of circulating vaccine-derived poliovirus in New York this summer, the ACIP added a “special situations” note to its polio vaccine guidance. The note advises that one lifetime IPV booster may be administered to individuals aged 18 years who have completed a documented three-dose polio vaccination series but are at increased exposure risk. It adds that those lacking documentation of a completed polio vaccination series can receive one, two or three doses to ensure full inoculation.

    Rockwell noted another urgent topic the committee addressed during the meeting: a recent spike in respiratory syncytial virus infections that has increased pediatric hospitalization rates. “RSV vaccines on the horizon were highlighted,” she said, noting that at least two potential RSV vaccines are in late-stage clinical trials and have shown signs of efficacy in older adults; an antiviral RSV drug is also being developed.

    The ACIP’s remaining recommendations centered on a handful of minor revisions, noted throughout this slide deck presented at the meeting. The ACIP will next meet Feb. 22-23. AAFP members can refer to the ACIP Meeting Information webpage for meeting agendas, slide decks and other materials.