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July 2008
Volume 18, Number 7
ACIP Makes New Recommendations on Rabies, HPV, Pneumococcal Vaccines
The federal Advisory Committee on Immunization Practices (ACIP) made the following recommendations at its June meeting in Atlanta, according to IDSA’s ACIP liaison, Samuel Katz, MD, FIDSA:

Rabies Pre-exposure Vaccination Discouraged: Due to the continuing shortage of rabies vaccine, pre-exposure prophylaxis is discouraged. Post-exposure prophylaxis should be initiated only on the basis of good evidence. In many states, vaccine can only be obtained through health departments. Two companies are licensed to produce rabies vaccine in the United States: Sanofi Pasteur, which is renovating its plant and may be back in production in 2009, and Novartis, which continues to produce and is building a new plant in Marburg, Germany. The companies hope to have more vaccine in the United States this summer.

HPV Vaccine Not Cost-beneficial for Women Over 26: Although there are no contraindications unique to women over age 26, the benefits of human papillomavirus (HPV) vaccine for this age group do not outweigh the costs, according to discussion at ACIP. Women may request the vaccine from their gynecologists or internists, but without ACIP’s recommendation most insurance companies will not pay for it. The vaccine costs about $500.

Pneumococcal Vaccine Recommended for Adults with Asthma: Asthma was added as a high-risk condition in the recommendations for adults age 18-64 years who should receive PPSV23 pneumococcal vaccine. ACIP also considered, but decided against, adding smoking to the list of high-risk conditions.

In other news, ACIP:

  • recommended adding two new pediatric combination vaccines—Kinrix and Pentacel—to the Vaccines for Children Program, which means the federal government will pay for them. Kinrix is a booster for diphtheria, tetanus, pertussis, and polio, and Pentacel protects against diphtheria, tetanus, pertussis, polio, and Haemophilus influenzae type b.
  • harmonized the schedule recommendations for rotavirus vaccines manufactured by Merck (RotaTeq) and GlaxoSmithKline (Rotarix)
  • discussed continued shortages of some varicella products. Zoster is still obtainable; MMRV is not and may not be until early 2009.

ACIP recommendations become official once approved by the Centers for Disease Control and Prevention and published in Morbidity and Mortality Weekly Report. For more information, see: http://www.cdc.gov/vaccines/recs/acip/.
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