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Treat with confidence. Trusted answers from the American Academy of Pediatrics.Treat with confidence. Trusted answers from the American Academy of Pediatrics.

Understanding Changes to the 2018

Immunization Schedule

H. Cody Meissner, MD, FAAP Professor of Pediatrics Tufts University School of Medicine


Disclaimer I have no financial relationships with the manufacturer(s) of

any commercial product(s) discussed in the presentation.

I will discuss the use of certain vaccines in a manner not consistent with the Package Insert, but all recommendations are in accordance with recommendations from the American Academy of Pediatrics (AAP) and Centers for Disease Control and Prevention (CDC).

Statements and opinions expressed are those of the author and not necessarily those of the AAP.


Objectives of Today’s Presentation

Understand the reason for change in timing of hepatitis B vaccine.

Review clarification of polio vaccine use relative to changes in global polio.

Discuss the current influenza season and recommendations for influenza vaccination.

Present basis for a 3rd dose of mumps-containing vaccine.


Title

Text


Changes to 6 Footnotes in the 2018 Schedule

Simplification of footnotes Changes to the following footnotes:

o Hepatitis B vaccineo Haemophilus influenzae type b vaccineo Polio vaccineso Influenza vaccineso Meningococcal vaccines o MMR (MMRV) vaccines

Reasons we vaccinate


Percentage of children aged <5 years withinvasive Haemophilus influenzae type b disease,

by vaccine status, 2002–2012


Polio Virus: The End Game Strategy


Global Polio Cases as of January 27, 2018

Endemic countries: Afghanistan, Nigeria, PakistanNon-endemic countries: Lake Chad Basin, Central Africa, Syrian Arab Republic


2017-18 Influenza Season Week Ending January 20, 2018


What’s New in 2017-18 for Influenza Vaccine Recommendations? Who should be vaccinated? Is LAIV recommended this season? Is vaccine recommended for pregnant women? What is the latest guidance for people with egg

allergy? Why isn’t quadrivalent vaccine recommended over

trivalent vaccine? Does simultaneous administration of IIV and PCV13

increase the risk of febrile seizure?


Mumps in the National Hockey League

Sidney Crosby in December 2015, Pittsburgh Penguins star


Complications of Mumps, Time Period Comparison


Mumps Viruses in US: 2015-3/2017

*as of March 1K: previously named K/MA: Jeryl-Lynn, vaccine (Merck)N: Leningrad-Zagreb (SII)

Genotype 2015 2016 2017* Total

G 112 623 160 895

C 2 3 5

H 3 1 4

K 2 1 1 4

N 3 1 4

A 1 1

Total 128 630 164 913


3rd Dose Mumps Virus-Containing Vaccine

“…a 3rd dose of a mumps virus-containing vaccine should be administered to persons previously vaccinated with 2 doses who are identified by public health authorities as being part of a group at increased risk for acquiring mumps because of an outbreak.”

Marin M, Marlow M, Moore KL, Patel M. Recommendation of the Advisory Committee on Immunization Practices for use of a third dose of mumps virus-containing vaccine in persons at increased risk for mumps during an outbreak. MMWR. 2018;67(1):33–38


Four Meningococcal Vaccines

1 Administer at least 4 weeks after all PCV doses2 May be given to people 56 years or older3 May be given to people 26 years or older


What is Required to Achieve Community Protection?

(Community or Herd or Indirect Immunity)


Community Protection (Herd Immunity)

Blue = not immunized but still healthy

Yellow = immunized but healthy

Red = not immunized, sick and contagious


Community Protection Important for: 1. Children/infants too young to be vaccinated2. Pregnant women 3. People in whom vaccine-induced immunity has waned4. Immunosuppressed patients who cannot be vaccinated5. Elderly people who may not mount an adequate immune

response to a vaccine6. People with inadequate access to vaccinations7. People who remain unvaccinated by choice


The End


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