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• W2327437550 abstract "On October 25–26, 2011, the CDC Advisory Committee on Immunization Practices (ACIP) met in Atlanta to review a number of vaccine-related topics, several of which are summarized below. Complete minutes of the meeting will be published on the CDC website (www.cdc.gov/vaccines/recs/acip). A review of incidence of hepatitis B from eight emerging infection program sites identified 865 cases of hepatitis. Of those patients, 11% (n = 95) had diabetes. Of the 756 patients with hepatitis aged 23 to 59 years, 68 (9%) had diabetes, and of the 109 older than 60 years, 27 (24.8%) had diabetes. The sites also reported that 19.5% of patients with diabetes and 34.6% of patients without diabetes had other risk factors for hepatitis B. The adjusted odds ratio for patients with diabetes having hepatitis B was 2.09 for patients aged 23 to 59 years and 1.45 among those older than 60 years. In summary, compared with people without diabetes, individuals with diabetes have a twofold higher risk for hepatitis B at age 23 to 59 years and a 1.5-fold higher risk at age greater than 60 years. Studies also revealed that the immune response or vaccine efficacy of the hepatitis B vaccine, along with all vaccines, was much better, as well as more cost effective, when given at a younger age. It was not cost effective after age 60 years. ACIP voted to recommend hepatitis B vaccination to adult patients with diabetes who are younger than 60 years (routine). Also, hepatitis B vaccination may be administered to unvaccinated adults with diabetes who are older than 60 years (permissive). The childhood and adolescent immunization schedules are slated to be published in February 2012. The basic layout of the schedules will not change. The footnotes for the schedule for children aged 0 to 6 years have been condensed and revised to save space. Also, a change was made to reflect the licensure of the meningococcal (groups A, C, Y, and W-135) polysaccharide diphtheria toxoid conjugate vaccine (Menactra—sanofi pasteur) for children aged 9 months. For the live attenuated influenza vaccine footnotes, contraindications were added and the wording edited to reflect changes in the two-dose recommendation of influenza vaccine to children younger than 9 years. The footnotes for the schedule for patients aged 7 to 18 years have been revised and condensed. This schedule also will be modified to reflect AClP’s revised HPV vaccine recommendations. In addition, the 16-year dose of meningo- coccal vaccine was added. The catch-up schedule was revised to reflect the above changes. Two adult vaccine schedules based on age and medical conditions will continue, and the schedules will be published in February 2012. Footnotes have been clarified and condensed. Changes to tetanus-diphtheria-pertussis vaccine in pregnancy and adults older than 65 years were added. HPV vaccine recommendations to health care providers were clarified to indicate that the vaccine is only recommended if the provider is in the regular age group for HPV vaccination. An additional clarification is that menin- gococcal vaccination is recommended for individuals no older than 21 years who live in residence halls if they did not have a dose at 16 years. For meningococcal vaccine, discussion focused on its routine use in infants. Three vaccines are licensed or under development. Menactra is licensed in infants aged 9 to 23 months and patients aged 2 to 55 years. Meningococcal (groups A, C, Y, and W-135) oligosaccharide diphtheria CRM197 conjugate vaccine (Menveo— Novartis) is licensed for patients 2 to 55 years of age and is under evaluation for infants at ages 2, 4, 6, and 12 months. Meningococcal (groups C and Y) and Haemophilus InOuenza type b combination vaccine (MenHibrix—GlaxoSmithKline) is under FDA review for infants at ages 2, 4, 6, and 12 months. The vaccines under review are safe and immunogenic. In addition, no interference occurred when the vaccines were given with seven-valent pneumococcal conjugate vaccine (PCV7; Prevnar 7—Pfizer). Rates of meningococcal disease have fallen to about 0.5 cases per 100,000 population. The disease is cyclical, so we could be in the midst of a low season. Although incidence of the disease is low currently, the severity is high. Pfizer has applied for FDA approval of Prevnar 13 (PCV13) use in adults 50 years or older, and approval is anticipated by January 1, 2012. PCV13 is indicated for the prevention of the 13 pneumococcal serotypes included in the vaccine. In one trial among patients older than 60 years, PCV13 was given 1 year after the 23-valent polysaccharide vaccine (PSV23; Pneumovax 23—Merck) and to PSV23-naive patients. If PCV13 was given following PSV23, antibody titers increased, but not as much as with two doses of PCV13 (for the serotypes in the vaccine). If PCV13 was given followed by a second dose of PCV13, a greater booster effect was seen if no PSV23 was given previously. The policy question is whether ACIP should recommend PCV13 for immunocompromised adults. Immunocompromised patients, especially those with asplenia, HIV, and cancer, as well as transplant patients, have a much higher incidence of pneumococcal disease. The working group recognized that the burden of disease and opportunities for prevention beyond PSV23 should be evaluated and will continue reviewing data to reach a conclusion when the vaccine is licensed." @default.
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• W2327437550 date "2012-01-01" @default.
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• W2327437550 title "Hep B, meningococcal, more discussed at ACIP meeting" @default.
• W2327437550 doi "https://doi.org/10.1016/s1042-0991(15)32053-3" @default.
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